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Full text of "Annual Report - Vital Statistics of Massachusetts, 2003"

3 



tal Statistics of Massachusetts 



MR 

614. 1M3 
S44r 
2003 
C.2 



State Library/f Massachusetti 
State l#use, Boston / 

/ / 



ANNUAL REPORT 
VITAL STATISTICS OF MASSACHUSETTS 
PUBLIC DOCUMENT #1 
2003 



THE COMMONWEALTH OF MASSACHUSETTS 
DEPARTMENT OF PUBLIC HEALTH 



DEVAL L. PATRICK, GOVERNOR 
TIMOTHY P. MURRAY, LIEUTENANT GOVENOR 
JUDYANN BIGBY, MD, SECRETARY OF HEALTH AND HUMAN SERVICES 
JOHN AUERBACH, COMMISSIONER OF PUBLIC HEALTH 



GERALD O'KEEFE, DIRECTOR 
CENTER FOR HEALTH INFORMATION, STATISTICS, RESEARCH, AND EVALUATION 



STANLEY E. NYBERG, REGISTRAR 
REGISTRY OF VITAL RECORDS AND STATISTICS 



150 MOUNT VERNON STREET, 1 st FLOOR 
DORCHESTER, MASSACHUSETTS 02125-3105 



March 2008 



Digitized by the Internet Archive 

in 2014 



https://archive.org/details/annualreportvitaOOmass 



The Commonwealth of Massachusetts 




Executive Office of Health and Human Services 

Department of Public Health 
250 Washington Street, Boston, MA 02108-4619 



DEVAL L. PATRICK 
GOVERNOR 

TIMOTHY P. MURRAY 
LIEUTENANT GOVERNOR 

JUDYANN BIGBY, MO 
SECRETARY 

JOHN AUERBACH 
COMMISSIONER 



March, 2008 

To the Honorable Senate and 
House of Representatives: 

We have the honor to submit as required by Chapter 111, Section 2 of the General Laws, the 
one hundred sixty-second annual report on statistics of births, deaths, marriages and divorces 
in Massachusetts for calendar year 2003. 

Since 1964, the ANNUAL REPORT OF VITAL STATISTICS has been published by the 
Department of Public Health and is intended to assist in the development of policy and 
programmatic initiatives within the Department, as well as to provide State officials and 
agencies, and the general public, with valuable statistical information. 



Sincerely, 




Stanley E. Nyberg, Ph.D. 
Registrar 



ACKNOWLEDGEMENTS 



This publication of the 2003 ANNUAL REPORT OF VITAL STATISTICS is the result of the 
combined efforts of all data providers, including the 351 city and town clerks, hospital 
personnel, physicians, funeral directors, probate courts, clinics, and Department of Public 
Health personnel. We gratefully acknowledge the assistance provided by all data providers, 
without whose efforts there would be no vital statistics. 

Department of Public Health staff most significantly involved in the production of the 2003 
ANNUAL REPORT OF VITAL STATISTICS include: 

Jane Purtill, Director, Statistics Unit: supervision of data collection, coding and 
editing. 

Sharon Pagnano and Paul Budrow: coordination of the hospital query program for 
birth certificate data, specialized data programming, and assistance in developing 
specialized table production; Maureen McKean (Statistics Unit), Robert Coffin 
(Nosologist), and Ann-Marie Neault (Nosologist): technical assistance; and Division of 
Data Processing: data file management and vital events series printouts. 

Isabel Caceres, Bruce Cohen, Malena Hood, and James West, Bureau of Information, 
Statistics, Research, and Evaluation: provided technical assistance and data, including 
the previously published: 

Massachusetts Births 2003 : Figures B-4, B-5, B-6, B-7, B-8, B-9, B-10, B-11 and 
D-3; as well as. Tables B-1, B-2A, B-2B, B-3A, B-3B, B-4, B-5A, B-5B, B-6. B-7A, B- 
7B, B-8, B-9, B-10, B-11, B-12, B-13, B-14, B-15, B-16A, B-16B, B16C, and D-2. 

Massachusetts Deaths 2003 : Figures C-1, C-2, C-3, and C-4; as well as. Tables C-1, 
C-2, C-3, C-3B, C-4A, C-4B, C-5, C-5B, C-6A, C-6B, C-7, C-8, and C-9, C-10, C- 
11 A, C UB, C-12A, C-12B, C-12C, C-1 2D C-1 3, C-15 ? D-1, D-3, and D-4. 

The joint efforts of all the staff of the Registry of Vital Records and Statistics are necessary 
to produce the data contained in this publication. Special acknowledgement is made to the 
following Registry supervisors: 

Pedro Fidalgo, Operations Unit Supervisor, who is responsible for all printing and 
mailing of forms; 

Pauline McNulty, Registration Unit Director, who is responsible for coordination with 
cities and towns, funeral directors, courts and the overall registration and amendment 
process; 

June Deloney, Registration Unit Supervisor, who is responsible for coordinating timely 
and accurate document processing. 



The 2003 ANNUAL REPORT OF VITAL STATISTICS has been compiled and produced under 
the general supervision and direction of: 

Stanley E. Nyberg, PhD., State Registrar 
Registry of Vital Records and Statistics 

Karin A. Barrett, Assistant State Registrar 
Registry of Vital Records and Statistics 

Charlene J. Zion, Information Officer 
Registry of Vital Records and Statistics 
Editor 

Kevin Y. Foster, Epidemiologist 
Registry of Vital Records and Statistics 
Editor 



Massachusetts Department of Public Health publications and materials can be accessed on 
the Internet. 

World Wide Web: Go to, http://www.mass.gov/dph/rvrs , and look under publications. 



CONTENTS 



TRANSMITTAL LETTER 
ACKNOWLEDGMENTS 
TABLE OF CONTENTS 
INTRODUCTION 



SECTION A-VITAL EVENTS 1 

Table A-1 Selected Facts in Vital Statistics, Massachusetts: 2003 5 

Figure A-1 2003 Massachusetts Daily Vital Events 6 

Table A-2 Number and Crude Rates of Vital Events, Massachusetts and 7 

United States: 2002-2003 

Figure A-2A Births and Deaths in Massachusetts, Selected Years: 1910-2003 8 

Figure A-2B Rates of Natural Increase in Massachusetts and the United 8 

States, Selected Years: 1910-2003 

Table A-3 Massachusetts Resident Births and Deaths with Resultant 9 

Natural Increase, Selected Years: 1900-2003 

Table A-4A Vital Events by Month, Massachusetts Residents: 2003 10 

Table A-4B Vital Events by Community: 2003 1 1 

Table A-4C Vital Events by County: 2003 22 

SECTION B -BIRTHS 23 

Figure B-1 Daily Birth Statistics, Massachusetts: 2003 34 

Table B-1 Trends in Birth Characteristics, Massachusetts: 1980, 1990- 25 

2003 

Table B-2A ^' rtn Characteristics by Maternal Race and Hispanic Ethnicity and gg 

Birthplace, Massachusetts: 2003 

Table B-2B Birth Characteristics by Maternal Ethnicity, Massachusetts: 2003 37 

Figure B-2 Resident Live Births by Mother's Race/Ethnicity: 2003 38 

Figure B-3 Resident Live Births by Mother's Age: 2003 39 

Table B-3A Resident Birth Characteristics, 30 Largest Municipalities, 40 

Massachusetts: 2003 



SECTION B--BIRTHS (continued) 
Table B-3B 



Table B-4 
Figure B-4 
Figure B-5 
Figure B-6 

Figure B-7 

Table B-5A 
Table B-5B 

Table B-6 

Table B-7A 

Table B-7B 

Figure B-8 

Table B-8 

Figure B-9 

Table B-9 

Table B-10 

Figure B-10 

Figure B-10 

Table B-1 1 

Table B-1 2 



Resident Birth Characteristics, Community Health Network Areas 42 
(CHNAs), Massachusetts: 2003 

Age-Specific and Crude Birth Rates, Massachusetts: 1990 and 44 
2003 

Trends in the Number of Births by Mother's Age Group, 45 
Massachusetts: 1980-2003 

Percent of Mothers Breastfeeding or Intending to Breastfeed by 46 
Age Group, Massachusetts: 2003 

Percent of Mothers who Smoked During Pregnancy by Mother's 47 
Race/Hispanic Ethnicity and Educational Attainment, 
Massachusetts: 2003 

Distribution of Smoking Status During Pregnancy by Smoking 48 
Status Prior to Pregnancy, Massachusetts: 2003 

Parity by Age of Mother, Massachusetts: 2003 49 

Trends in Number and Percent Distribution of Births by Plurality 50 
and Age, Massachusetts: 1990-2003 

Selected Birth Characteristics by Maternal Education, 51 
Massachusetts: 2003 

Interpregnancy Intervals ( I PI ) and Birth Outcomes, Pregnancies to 52 
Multiparous Mothers, Massachusetts: 2003 

Interpregnancy Intervals (IPI) by Maternal Characteristics, 53 
Pregnancies to Multiparous Mothers, Massachusetts: 2003 

Low Birthweight Among Smoking and Nonsmoking Mothers by 54 
Race and Hispanic Ethnicity, Massachusetts: 2003 

Summary of Selected Teen Birth Characteristics, Massachusetts: 55 
2003 

Comparison of Teen vs. Adult Births, Selected Characteristics, 56 
Massachusetts: 2003 

Resident Teen Birth Characteristics, 30 Largest Municipalities, 57 
Massachusetts: 2003 

Trends in Teen Birth Rates for Selected Communities, Ranked by 59 
2003 Teen Birth Rate, Massachusetts: 2003, 2002, 1993 

Adequacy of Prenatal Care for Selected Population 60 
Characteristics, Massachusetts: 2003 

Trends in Adequacy of Prenatal Care by Race and Hispanic 61 
Ethnicity, Massachusetts: 1996-2003 

Adequacy of Prenatal Care by Selected Characteristics, 62 
Massachusetts: 2003 

Birth Characteristics by Race/Hispanic Ethnicity and Source of 64 
Prenatal Care Payment (Public/Private), Massachusetts: 2003 



SECTION B -BIRTHS (continued) 



Table B-13 

Table B-14 

Table B-15 
Table B-16A 
Table B-16B 
Table B-16C 

SECTION C -DEATHS 

Figure C-1 
Table C-1 
Figure C-2 

Table C-2 
Table C-3 

Table C-4A 
Table C-4B 
Figure C-3 
Table C-5 



Cesarean Section Deliveries and Vaginal Births after Cesarean 
Section (VBACs) by Licensed Maternity Facility, All Births, 
Massachusetts: 2003 

Cesarean Section Deliveries for Singleton Births by Licensed 
Maternity Facility and Number of Previous Births, 
Massachusetts: 2003 

Birth Characteristics by Licensed Maternity Facility, 
Massachusetts: 2003 

Birth Characteristics: Occurrence and Resident Births and Infant 
Deaths, Massachusetts Municipalities: 2003 

Birth Characteristics: Occurrence and Resident Births and Infant 
Deaths by County, Massachusetts: 2003 

Birth Characteristics: Occurrence and Resident Births and Infant 
Deaths, Massachusetts Community Health Network Areas 
(CHNAs): 2003 



Daily Death Statistics, Massachusetts: 2003 

Trends in Mortality Characteristics, Massachusetts: 1993-2003 

Expected Years of Life Remaining at Different Ages by Race/ 
Hispanic Ethnicity, Massachusetts: 2003 

Years of Life Remaining, Massachusetts: 2003 

Five Leading Causes of Death Comparability Unmodified and 
Comparability Modified Age-Adjusted Rates, Massachusetts and 
United States: 1993-2003 

Leading Causes of Death, Numbers and Age-Specific Rates by 
Gender, Massachusetts: 2003 

Leading Causes of Death, Numbers and Age-Specific Rates 
(Ages 65 and older) by Gender, Massachusetts: 2003 

Trends in Deaths from Selected Causes, Massachusetts: 1842- 
2003 

Leading Causes of Death and Age-Adjusted Death Rates by Race 
and Hispanic Ethnicity, Massachusetts: 2003 



SECTION C -DEATHS (continued) 
Figure C-4 



Table C-6A 
Table C-6B 

Table C-7 

Table C-8 

Table C-9 
Table C-10 

Table C-11A 

Table C-11B 

Table C-11C 

Table C-11D 

Table C UE 

Table C-12A 

Table C-12B 
Table C-12C 

Table C-12D 

Table C-13 
Table C-14A 



Percent Distribution of Leading Causes of Death, Massachusetts: 103 
2003 

Number and Age-Specific Rates for Selected Causes of Death by 1 04 
Race and Hispanic Ethnicity, Massachusetts: 2003 

Number and Age-Specific Rates for Selected Causes of Death, 105 
Persons age 65+ by Race and Hispanic Ethnicity, 
Massachusetts: 2003 

Heart Disease and Cancer Deaths by Race and Gender, 106 
Comparability Unmodified and Comparability Modified Age- 
Adjusted Rates, Massachusetts: 1997-2003 

Number and Age-Adjusted Rates of Cancer Deaths by Selected 1 08 
Causes and Gender, Massachusetts: 2003 

Selected Causes of Cancer Deaths by Age, Massachusetts: 2003 109 

Leading Causes of Cancer Deaths and Age-Adjusted Rates by 110 
Race and Hispanic Ethnicity, Massachusetts: 2003 

Injury Deaths by Leading Causes, Gender, Age, Race and Hispanic 111 
Ethnicity: Numbers, Age-Adjusted, and Age-Specific Rates, 
Massachusetts: 2003 

Intentional Injury Deaths by Gender, Age, Race and Hispanic 113 
Ethnicity: Numbers, Age-Adjusted, and Age Specific Rates, 
Massachusetts: 2003 

Injury Deaths by Intent, Method, and Gender: Number and Age- 115 
Adjusted Rates, Massachusetts: 2003 

Type of Injury Deaths by Method / Intent Categories: Numbers 116 
and Age-Adjusted Rates, Massachusetts: 2003 

Poisoning Deaths of Undetermined Intent by Agent, 117 
Massachusetts: 2003 

HIV/AIDS Deaths by Place of Occurrence, Massachusetts: 1991- 118 
2003 

HIV/AIDS Deaths by Age, Massachusetts: 1991-2003 119 

HIV/AIDS Deaths by Gender, Race and Hispanic Ethnicity, -j 20 

Massachusetts: 1991-2003 

HIV/AIDS Deaths by Gender, Race, and Hispanic Ethnicity 121 
Numbers, Percent, and Age-Adjusted Rates, Massachusetts: 
1999-2003 

HIV/AIDS Deaths by Race, Hispanic Ethnicity, and Gender: 122 
Persons Ages 25-44, Massachusetts: 1991-2003 

Medical Examiner Certified Deaths by Cause, Race, Sex, and Age, 123 
Massachusetts Occurrence: 2003 



SECTION C--DEATHS (continued) 



Figure C-5 

Table C-14B 

Table C-15A 
Table C-1 5B 

Table C-15C 
Table C-1 6 



Proportion of Deaths Certified by Medical Examiner for Selected 1 26 
Causes of Death, Massachusetts Occurrence Deaths: 2003 

Medical Examiner Certified Deaths by County, Massachusetts 1 27 
Occurrence: 2003 

Selected Causes of Death by Community, Massachusetts: 2003 1 28 

Selected Causes of Death by Community Health Network Area 1 38 
(CHNA), Massachusetts: 2003 

Selected Causes of Death by County, Massachusetts: 2003 139 

Resident Deaths by Cause, Sex, and Race, Massachusetts: 140 
2003 



SECTION D--INFANT & NEONATAL DEATHS 



159 



Figure D-1 
Figure D-2 
Table D-1 

Table D-2 

Table D-3 

Table D-4 

Figure D-3 



Infant Mortality Rates by Race, Massachusetts: 1980-2003 162 

Neonatal Mortality Rates by Race, Massachusetts: 1980-2003 163 

Trends in Infant, Neonatal, and Post-Neonatal Mortality by Race 1 64 
and Hispanic Ethnicity, Massachusetts: 1990-2003 

Trends in Infant, Neonatal, and Post-Neonatal Mortality by Race, 1 66 
Massachusetts: 1980-2003 

Infant, Neonatal, and Post-Neonatal Deaths by Cause, 1 69 
Massachusetts: 2003 

Infant Deaths by Major Causes, Race and Hispanic Ethnicity, 170 
Massachusetts: 2003 

Infant Mortality Rates, Massachusetts: 1842-2003 171 



SECTION E -MARRIAGES & DIVORCES 



173 



Figure E-1 
Table E-1 
Table E-2 

Table E-3 



Rates of Marriages and Divorces per 1,000 Population, Selected 174 
Years, Massachusetts: 1900-2003 

Marriages and Divorces by County, Massachusetts Occurrence: 175 
2003 

Marriages and Divorces: Numbers and Rates per 1 ,000 1 76 

Population, Massachusetts Occurrence, Selected Years: 1900- 

2003 

Marriages by Age and Marital Status, Massachusetts 177 
Occurrence: 2003 



SECTION E-MARRIAGES & DIVORCES (continued) 

Table E-4 Number of Marriages by Age of Bride and Age of Groom, 1 78 

Massachusetts Occurrence: 2003 

Table E-5 Number of Marriages for Bride by Number of Marriages for 1 78 

Groom, Massachusetts Occurrence: 2003 

SECTION F--POPULATION 179 

Figure F-1 Massachusetts Population: 1900-2003 180 

Table F-1 Population Estimates by Race, Ethnicity, Age, and Sex, 181 

Massachusetts: 2003 

Figure F-2 Population by Age Group, Massachusetts: 2003 1 83 

Figure F-3 Population by Race/Hispanic Ethnicity, Massachusetts: 2003 1 84 

Figure F-4 Changes in Age Composition of the Population, Massachusetts: 185 

1900-2000 

Table F-2 Massachusetts Population by County: 1930-2000 186 

Table F-3 Massachusetts Population by City and Town: 1980, 1990 and 187 

2000 US Census 

Table F-4 Population Counts and Estimates, Massachusetts: 1980, 1985- 

2003 

APPENDICES 199 

I Source Documents 

Standard Certificate of Live Birth 1 99 

Standard Certificate of Death 200 

Report of Fetal Death 201 

Certificate of Marriage 202 

Certificate of Absolute Divorce or Annulment 203 



II 



Registry of Vital Records and Statistics Staff 



203 



INTRODUCTION 



The ANNUAL REPORT OF VITAL STATISTICS (Public Document No. 1 ) has been published 
continuously since 1842. This is the 40th edition produced by the Department of Public 
Health. This report, required under the provisions of Chapter 111, section 2, of the 
Massachusetts General Laws, tabulates data on Massachusetts births, fetal deaths, deaths, 
marriages, divorces, and population for calendar year 2003. The report provides its users 
with an overview of the health status of the Massachusetts population. The report can be 
accessed at http://www.mass.gov/dph. 

Vital statistics data may be tabulated either in terms of resident data or occurrence data. 
Resident data include all events which occur to residents of the Commonwealth, wherever 
the events occur. Occurrence data include all those events, which occur within the state, 
including those which occur to out-of-state residents. There is an interstate exchange of 
copies of birth and death records among the fifty states, the District of Columbia, Puerto 
Rico, the U.S. Virgin Islands, Guam, and all Canadian provinces. These records are 
exchanged for statistical purposes only, for events which occur in states or provinces other 
than where the individual resides. This exchange allows each of the states and provinces to 
track the births and deaths of their residents. The majority of the data presented in this 
report for births and deaths is based on resident data. Marriage, divorce, and fetal death 
data, however, only reflect events that occurred within the Commonwealth. 

REGISTRATION 

The first government-operated system of vital events registration anywhere in the world 
began in the Commonwealth of Massachusetts in 1639 under colonial administration. Prior 
to that time, in countries with a vital registration system such as England, the responsibility 
for the registration of vital events had been placed on church officials. The Massachusetts 
system mandated the registration of vital events by the clerks of the communities. In 1842, 
the Massachusetts legislature established the first statewide coordination for the registration 
of these events by requiring that copies of the events registered in the local cities and towns 
be sent to the Secretary of State. The collection of vital events began with the records of 
1841. The collection of data and the production of the ANNUAL REPORT OF VITAL 
STATISTICS has continued since then. With the exception of the administrative location of 
the State Registry, the actual mechanics of the system have changed remarkably little over 
the years. 

With limited exceptions, most vital records in Massachusetts are open records. For open 
birth and death records, there is a triple registration process in Massachusetts. The event is 
first recorded in the city or town where the event occurred. Originally, the clerk would send 
the state a copy of the event. Beginning in 2000, the clerk of that community has been 
required to forward the original record to the State Registry and an attested copy to the 
community where the person resided at the time of the event. Certified copies of the 
records may be issued from local or state records. If the record is a restricted birth record, 
such as those of out-of-wedlock births, the registration occurs only in the community where 
the event occurred and in the state office unless the mother gives permission for the resident 
community to receive a copy. In addition to receiving a legal copy of each birth record from 
the city or town in which the birth occurred, the State Registry also receives information 
about the birth record directly from the hospital or birthing center where the birth occurred. 



These data include confidential medical information in addition to the legal information. This 
medical information is processed to produce the statistical information on births contained in 
this report. 

Since 1986, the State Registry has utilized a program of direct electronic transmission of 
birth records from hospitals. The system used in Massachusetts is called the Electronic Birth 
Certificate (EBC). Most birth records are now received through this method. EBC has 
contributed to reducing processing time at both the hospital and the State Registry, while the 
system's built-in edits increase the quality of the data. 

The process for creating death certificates is the most complex of all vital records. Complete 
and accurate death records are dependent upon the following individuals: 1.) Certifier, who 
not only initiates the death registration process but also determines the cause of death as 
well as the place, time, and date of death; 2.) Funeral Director, who plays the role of 
facilitator in the death registration process and adds the personal data concerning the 
decedent, which are supplied by an informant; 3.) Burial Agent, who both issues the permit 
that allows the chosen disposition to take place and serves as the initial acceptor of the 
death certificate for official registration; and 4.) City or Town Clerk, who records the death 
certificate, issues certified copies and forwards the original death record to the Registry of 
Vital Records and Statistics and other communities as required by law. 

Beginning in 1999, the ICD-10 (International Classification of Diseases-Tenth Revision) 
replaced the ninth revision as a means of classifying cause of death. The ICD-10, developed 
by the World Health Organization, is an international classification system employed by the 
United States in order to promote international comparability in collecting, classifying, and 
tabulating mortality statistics. 

The Registry of Vital Records and Statistics receives directly from hospitals or physicians the 
fetal death reports for fetuses of either twenty or more weeks gestation or weighing at least 
350 grams. There are no local filings of fetal death reports. 

Marriage licenses may be issued from any of the 351 cities or towns regardless of where the 
marriage is to take place. The community issuing the license is required to submit an attested 
copy of the marriage record to the State Registry. For the 2003 marriage records, the event 
is recorded only in the community where the notice of intention to marry was filed and at the 
State Registry. 

Abstracts of divorces granted are also sent directly to the State Registry from the Registers 
of Probate from each county probate court. 

STATISTICAL PROCESSING AND TABULATING 

The records received in the State Registry are carefully examined for legal errors and 
inconsistencies. As part of the computerization process, errors and inconsistencies are 
queried and corrected. A computerized hospital query program is part of the EBC program. 
The Registry also has a data quality assurance program that includes on-site instruction for 
clerks and hospital personnel who have reporting difficulties, and training for all groups 
involved in the data collection process. 



Annually, when registration is considered as complete as possible, statistics are aggregated 
for presentation in this report, in special studies, and for program monitoring and 
surveillance. 

Anyone using statistical information for comparisons over time should be aware of 
inconsistencies and changing conventions for classification and coding. This is particularly 
important when using cause of death information. Codes used for classifying cause of death 
in this report are based on the Tenth Revision of the International Classification of Diseases, 
World Health Organization. Classification of variables such as race, nativity, and marital 
status may also differ over time. 

It is hoped that this report will be useful to a wide range of health data users in the 
Commonwealth, as well as to educational planners, demographers, and historians. 
Questions concerning these data and requests for more detailed findings should be directed 
to: 

Massachusetts Department of Public Health 
Registry of Vital Records and Statistics 
150 Mount Vernon Street 
Dorchester, Massachusetts 02125-3105 
(617) 740-2670 



VITAL EVENTS 



SECTION A 
VITAL EVENTS 

HIGHLIGHTS 
BIRTHS 

In 2003, there were 80,167 births to Massachusetts residents. 
Births decreased by 0.6% from 2002 to 2003. 

The 2003 Massachusetts birth rate per 1,000 residents was 12.4, a decrease 
of 1.6% from the birth rate of 12.6 in 2002. 

Massachusetts' 2003 birth rate of 12.4 per 1,000 residents was below the 
2003 US birth rate of 14.1. 

• The most births occurred in July (9.2%--7,363 births); the fewest births 
occurred in February (7.5%--6,050 births). 



DEATHS 

• In 2003, 56,194 Massachusetts residents died. 

• The number of resident deaths decreased by 1.2% from 2002 to 2003. 

• The Massachusetts crude death rate decreased from 885.7 deaths per 
100,000 residents in 2002 to 872.2 in 2003. The 2003 US crude death rate of 
841.9 deaths per 100,000 residents was lower than the 2002 US crude death 
rate of 847.3. The 2003 age-adjusted death rate in Massachusetts (810.2 per 
100,000 residents) was lower than the US age-adjusted death rate (832.7). 

• The most deaths in 2003 occurred in December (9.9%-5,529); the fewest 
deaths occurred in September (7.3%~4,296). 



FETAL DEATHS 

There were 464 reportable fetal deaths to Massachusetts residents in 2003. 

• The number of reportable fetal deaths increased by 89 from 2002 to 2003, 
resulting in a fetal death rate of 5.8 per 1,000 live births. 



l 



INFANT DEATHS 



In 2003, 383 infant deaths (less than 1 year of age) occurred to 
Massachusetts residents. 

The 2003 Massachusetts infant mortality rate of 4.8 deaths per 1,000 live 
births was a slight decrease from the 2002 infant mortality rate of 4.9 deaths 
per 1,000 live births. 

The Black non-Hispanic infant mortality rate increased from 11.6 in 2002 to 
12.7 in 2003. 

The Massachusetts 2003 infant mortality rate of 4.8 per 1,000 live births was 
30% below the US infant mortality rate of 6.9. 



MARRIAGES 

• In 2003, there were 36,224 marriages in Massachusetts. 

• The number of marriages in Massachusetts decreased by 4.0% from 2002 to 
2003. 

• The 2003 Massachusetts rate of 5.6 marriages per 1,000 population was 
below the US marriage rate of 7.7. 

• The most marriages occurred in August (13.3%~4,807); the fewest marriages 
occurred in January (3.6%-1,318). 

DIVORCES 

• In 2003, 15,738 divorces were granted in Massachusetts. 

• Divorces in Massachusetts decreased by 3.2% from 2002 to 2003. 

• The 2003 Massachusetts divorce rate of 2.4 divorces per 1,000 population 
was below the US divorce rate of 3.8. 

• The largest number of divorces were finalized in January (1,507-9.6%), and 
the fewest in November (991-6.3%). 



NATURAL INCREASE 

• The rate of natural increase in the Massachusetts resident population 
remained relatively constant from 2002 to 2003 at 3.7. 

The 2003 US natural increase rate of 5.8 remains above that of 
Massachusetts. 



2 



The Vital Events section provides basic information on all vital events. In addition to the 
information highlighted above, this section contains summary birth and death data by city, 
town and county. More detailed information is contained in the sections on the individual 
events. 



DEFINITIONS IMPORTANT FOR THIS SECTION INCLUDE: 
LIVE BIRTH 

A live birth is any infant who breathes or shows any other evidence of life (such as beating 
of the heart, pulsation of the umbilical cord, or definite movement of voluntary muscles) 
after separation from the mother's uterus, regardless of the duration of gestation. 

FETAL DEATH 

A fetal death is a death prior to the complete expulsion or extraction from its mother of a 
product of conception, irrespective of the duration of the pregnancy; the death is indicated 
by the fact that after such separation, the fetus does not breathe or show any other 
evidence of life, such as the beating of the heart, pulsation of the umbilical cord, or definite 
movement of the voluntary muscles. 

Massachusetts law requires that fetal deaths of 20 or more weeks gestation or weighing at 
least 350 grams be reported; therefore, the fetal deaths referred to in this report are of that 
gestational age or weight. 

INFANT DEATH 

Death of a child whose age is less than one year (365 days). 



MISER 

The Massachusetts Institute for Social and Economic Research. This research institute, 
which was located at the University of Massachusetts in Amherst, produced the official 
population estimates and projections for the Commonwealth before 2000. 



NATURAL INCREASE 

The difference between the number of resident live births and the number of resident 
deaths. 



NEONATAL DEATH 

Death of a child whose age is less than 28 days. 



3 



OCCURRENCE 



Occurrence data reflect where the event took place without regard to residence. In 
Massachusetts, place of occurrence will be one of 351 cities or towns. 



RESIDENCE 

The usual place of residence as reported by the mother (for births) or the informant (for 
deaths). An infant's residence is considered that of the mother. While occurrence data 
include only events that occurred within Massachusetts, residence data for births and 
deaths include those which may or may not have occurred in Massachusetts. 



CRUDE RATES OF VITAL EVENTS: 



BIRTH RATE 



No. of Resident Live Births x 1,000 
Total Resident Population 



FETAL MORTALITY RATE Number of Resident Fetal Deaths 



x 1,000 



Resident Live Births + Resident Fetal Deaths 

INFANT MORTALITY RATE No. of Resident Deaths <1 Year x 1,000 

Resident Live Births 



NEONATAL MORTALITY No. of Resident Deaths <28 Days x 1,000 
RATE Resident Live Births 



DEATH RATE 



No. of Resident Deaths x 100,000 
Total Resident Population 



MARRIAGE RATE 



No. of Occurrence Marriages x 1,000 
Total Resident Population 



DIVORCE RATE 



No. of Occurrence Divorces x 1,000 
Total Resident Population 



4 



Table A-1 
Selected Facts in Vital Statistics, 
Massachusetts: 2003 







BIRTH 




Age Range of Fathers: 1 3-73 






Age Range of Mothers: 1 2-52 


Sets of Twins: 1 .776 


Sets of Triplets: 82 Sets of Quadruplets: 2 


Most Births Occurred on: June 20, 2003 (298 births) 






Fewest Births Occurred on: December 7, 2003 (116 births) 


Highest # of Births at Brigham and Women's Hospital (9,402) 






Lowest # of Births at North Shore Birth Center (88 births) 


Twenty Most Popular Names for Boys 






Twenty Most Popular Names for Girls 


Boys' Names Number Boys' Names Number 


Girts' Names Number Girls' Names Number 


Matthew 772 Benjamin 


499 


Emma 


641 Madison 345 


Michael 766 Daniel 


494 


Emily 


631 Sophia 344 


Ryan 698 Christopher 


483 


Olivia 


536 Elizabeth 340 


Nicholas 677 Alexander 


478 


Abigail 


454 Ashley 313 


John 612 Anthony 


465 


Isabella 


399 Ava 276 


Joseph 585 Aidan 


456 


Sarah 


388 Anna 239 


Jacob 576 James 


439 


Grace 


384 Lauren 239 


William 553 Tyler 


439 


Hannah 


365 Jessica 237 


Andrew 530 Jack 


419 


Julia 


351 Victoria 234 


Joshua 507 Zachary 


396 


Samantha 


348 Caroline 233 




c 


)EATH 




Male Decedents 100 Years and Older: 64 






Female Decedents 100 Years and Olden 466 


Most Deaths Occurred on: February 22, 2003 (219) 






Fewest Deaths Occurred on: August 24, 2003 (109) 


Month Most Suicides Occurred: December (46) 






Month Most Homicides Occurred: August (18) 


Month Most Motor Vehicle Deaths Occurred: June & November (44) 




MARRIAGE 




Ages of Grooms: 17-97 years (average: 33.4) 






Ages of Brides: 14-91 years (average: 32.1) 


Age of First Time Grooms: 17-93 years (average: 30.3) 






Age of First Time Brides: 14-79 (average: 28.5) 


Most Popular Month for Marriages: August (4,807) 






Least Popular Month for Marriages: January (1,318) 


Most Marriages Occurred on: June 21, 2003 (797) 






Fewest Marriages Occurred on: January 20, 2003 (6) 


Greatest Age Difference When Groom Older than Bride: 49 years 




Greatest Age Difference When Bride Older than Groom: 49 years 




DIVORCE 




Length of Marriages Involved in Divorces: < 1 Year to 57 Years of Marriage 


Most Common Length of Marriage Prior to Divorce: 6 years 


Month Most Divorces Granted: January (1,507) 






Month Fewest Divorces Granted: November (991 ) 



5 



Figure A-1 

2003 Massachusetts Daily Vital Events 

Each day in 2003, Massachusetts residents had approximately: 



220 

Live 
Births 



99 

Marriages 




37 

Cancer 
Deaths 



1 

Infant 
Death 



7 

Injury 
Deaths 



154 
Deaths 



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Figure A-2A. Births and Deaths in Massachusetts, Selected Years: 1910-2003 




Figure A-2B. Rates of Natural Increase for Massachusetts and the United States, Selected 

Years: 1910-2003 




8 



Table A-3. 


Massachusetts Resident Births and Deaths with Resultant Natural Increase 






Selected Years: 1900-2003 












Natural 


Rate/1,000 


Year 


Births 


Deaths 


Increase 


Residents 


1900 


73,386 


51,156 


22,230 


7.9 


1905 


75,022 


50,486 


24,536 


8.2 


1910 


86,539 


54,407 


32,132 


9.5 


1915 


93,155 


53,131 


40,024 


10.8 


1920 


91,859 


53,632 


38,227 


9.9 


1925 


86,014 


51,890 


34,124 


8.2 


1930 


73,690 


49,503 


24,187 


5.7 


1935 


62,416 


49,634 


12,782 


2.9 


1940 


65,369 


50,698 


14,671 


3.4 


1945 


76,455 


50,763 


25,692 


5.7 


1950 


95,619 


50,359 


45,260 


9.6 


1955 


109,610 


53,386 


56,224 


11.6 


1960 


114,018 


56,560 


57,458 


11.2 


1965 


100,262 


58,853 


41,409 


7.8 


1970 


93,582 


56,944 


36,638 


6.4 


1975 


68,070 


53,708 


14,362 


2.5 


1980 


72,591 


54,934 


17,657 


3.1 


1981 


73,930 


52,813 


21,117 


3.7 


1982 


75,749 


52,867 


22,882 


4.0 


1983 


76,031 


54,150 


21,881 


3.8 


1984 


78,197 


55,189 


23,008 


4.0 


1985 


81,781 


c c c r\~7 

55,597 


ZD,1o4 


A C. 

4.0 


1986 


82,168 


55,860 


26,308 


4.5 


1987 


84,345 


55,562 


28,783 


4.9 


1988 


88,047 


56,407 


31,640 


5.4 


1989 


91,314 


53,748 


37,566 


6.4 


1990 


92,461 


53,008 


on ^ co 


D.D 


1991 


88,176 


53,010 


35,166 


5.8 


1992 


87,202 


53,804 


33,398 


5.5 


1993 


84,627 


55,557 


29,070 


4.8 


1994 


83,758 


54,914 


28,844 


4.7 


1995 


81,562 


55,296 


2o,zob 


A 1 

4.o 


1996 


80,164 


55,187 


24,977 


4.0 


1997 


80,321 


54,634 


25,687 


4.1 


1998 


81,406 


55,204 


26,202 


4.2 


1999 


80,866 


55,763 


25,103 


4.0 


^UUU 


81,582 


56,591 


24,991 


3.9 


2001 


81,104 


56,733 


24,371 


3.8 


2002 


80,624 


56,881 


23,743 


3.7 


2003 


80,167 


56,194 


23,973 


3.7 



9 



Table A-4A. Vital Events by Month, Massachusetts Residents: 2003 




Births 


Fetal 
Deaths 1 


Deaths 


Infant Neonatal 
Deaths 2 Deaths 2 Marriages 


Divorces 


Totals 


80,167 


463 


56,194 


383 285 36.224 


15,738 



January 


if 


6,326 


A A 

40 


5,436 


35 


27 


1,318 


1,507 




Rank 


9 


4 


2 


4 


4 


12 


1 


February 


# 


6,050 


40 


4,673 


30 


20 


1,680 


1,277 




Rank 


19 


A 


A 

*T 


q 


q 


1 1 


q 


March 


# 


6,710 


34 


4,907 


33 


26 


1,704 


1,361 




Rank 


7 


1 1 


3 


8 

<-* 


5 


10 


5 


April 


it 
# 


6,662 


29 


4,618 


34 


26 


2,098 


1,232 




Rank 

I vol lf\ 


R 

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12 


ft 


5 


5 


8 


11 


May 


# 


7,009 


44 


4,349 


40 


31 


3,787 


1 ,371 




Rank 


2 


2 


10 


1 


1 


5 


4 


June 




6,886 


1 4 

44 


A A 4 O 

4,416 


36 


29 


4,4yy 


1 ,6( o 




Rank 


5 


2 


9 


2 


3 


2 


3 


July 


# 


7,363 


36 


4,522 


34 


21 


3,586 


1.341 




Rank 


1 


9 


7 


5 


8 


6 


6 


August 


# 


6,904 


46 


4,317 


24 


16 


4,807 


1,285 




Rank 


4 


1 


11 


11 


11 


1 


8 


September 


# 


6,961 


40 


4,296 


36 


31 


4,469 


1,450 




Rank 


3 


4 


12 


2 


1 


3 


2 


October 


# 


6,803 


38 


4,646 


28 


19 


4,230 


1,291 




Rank 


6 


7 


5 


10 


10 


4 


7 


November 


# 


6,213 


35 


4,485 


21 


16 


2,322 


991 




Rank 


11 


10 


8 


12 


11 


7 


12 


December 


# 


6,306 


37 


5,529 


32 


23 


1,724 


1,254 




Rank 


10 


8 


1 


7 


7 


9 


10 



'Fetal deaths are not included in Births or Deaths. 2 lnfant deaths and neonatal deaths are included in total resident deaths; 
neonatal deaths are included in infant deaths. 



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22 



BIRTHS 



SECTION B 



BIRTHS 

There were 80,167 live births to Massachusetts residents in 2003, a 0.6% decrease from the 
80,624 resident live births in 2002. Live births to Massachusetts residents include all births 
to Massachusetts residents, regardless of the state in which the births occurred. Most data 
presented in this section are resident data. Table B-13 presents births by licensed 
maternity facility of occurrence, which includes births to women who live in other states. 



OCCURRENCE BIRTHS 

In 2003, 81,310 births occurred in Massachusetts. All but 327 births occurred at the 52 
licensed maternity facilities in this state. The number of babies delivered at these 
maternity facilities ranged from 88 at the North Shore Birth Center in Cambridge to 9,402 at 
Brigham and Women's Hospital in Boston. The four hospitals with the greatest numbers of 
births were Brigham and Women's Hospital (9,402), Beth Israel Deaconess Medical Center 
(5,035), Baystate Medical Center (4,283), and UMASS Memorial Medical Center - West 
Campus (4,473). These four hospitals represented 28.5% of all births occurring in 
Massachusetts. The distribution of Massachusetts births by hospital size is presented 
below. 



2003 DISTRIBUTION OF MASSACHUSETTS 
OCCURRENCE BIRTHS BY FACILITY 



NUMBER OF 
BIRTHS AT 
HOSPITAL 


NUMBER OF 
HOSPITALS IN 
CATEGORY 


TOTAL NUMBER 
OF BIRTHS IN 
CATEGORY 


%OF 
TOTAL 
BIRTHS 


<500 


10 


2084 


2.6 


500-999 


12 


8350 


10.3 


1000-1499 


11 


13572 


16.7 


1500-1999 


8 


14091 


17.3 


>2000 


11 


42885 


52.7 


All other 1 




328 


.4 


TOTAL 


52 


81,310 


100.0 



1 Includes hospitals without maternity units, home births, births en route to hospital and births occurring in a doctor's office/clinic. 



BIRTHS BY RACE/ETHNICITY 



There are two points to keep in mind when analyzing 2003 data by race/ethnicity. First, 
since June 1986, information on both race and ethnicity rather than just race has been 
collected. This provides improved data, particularly for Hispanic births. Presented for 
comparison below are resident birth data for calendar years 2002 and 2003, utilizing 
maternal race and Hispanic ethnicity information: 



RACE AND HISPANIC ETHNICITY OF MOTHER 
2002 - 2003 



MATERNAL 
RACE/ETHNICITY 


2003 


2002 


CHANGE 
(1997-1998) 


TOTAL 
BIRTHS 


%OF 
BIRTHS 


TOTAL 
BIRTHS 


%OF 
BIRTHS 


White non-Hispanic 


57,604 


71.9 


58,136 


72.1 


-532 


Black non-Hispanic 


5,902 


7.4 


5,948 


7.4 


-46 


Hispanic 


9,764 


12.2 


9,543 


11.8 


221 


Asian 


5,224 


6.5 


5,300 


6.6 


-76 


Other 1 


1,548 


1.9 


1,576 


2.0 


-28 


Unknown 2 


125 


0.2 


121 


0.2 


4 


TOTAL 3 


80,167 


100 


80,624 


100 


-457 



' Other races include American Indian, Hawaiian, and Other. 

2 Unknown race: mothers did not indicate a race/ethnicity. 

3 Percents do not sum to 100.0 due to rounding. 



The other point which must be considered is the method used to present data by 
race/ethnicity. Massachusetts follows the recommendation from the National Center for 
Health Statistics (NCHS) by classifying race/ethnicity on the birth certificate according to 
the self-reported race/ethnicity of the mother. Beginning with 1989 births, birth data are 
presented by race/ethnicity of the mother only. 



TEEN BIRTHS 

The number of births to mothers aged 15-19 decreased slightly from 4,642 in 2002 to 4,639 
in 2003. The teen birth rate remained fairly constant at 22.6 births per 1,000 women aged 
15-19 during these years. The percentage of total births to women under age 20 continues 
to decrease markedly, from a peak of 12.7% in 1975 to 5.8% in 2003. 



24 



BIRTHS BY MARITAL STATUS 



The percentage of births to unmarried women increased from 26.8% of all resident births in 
2002 to 27.8% of all resident births in 2003. Over 90% of mothers under the age of 20 were 
unmarried while 23.8% of the mothers who were 20 years of age or older were unmarried. 

BIRTHS BY AGE OF MOTHER 

The largest percentage increases in births between the years 2002 and 2003 (5.7%) were to 
mothers in the 40-44 age group, as shown below. The percentage change in the 45+ age 
group is based on relatively few births and should be interpreted with caution. 



AGE OF 
MOTHER 


NUMBER OF 
BIRTHS 
2003 


NUMBER OF 
BIRTHS 
2002 


DIFFERENCE IN 
THE NUMBER OF 
BIRTHS 
2002-2003 


PERCENTAGE 
CHANGE 
2002-2003 


<20 


4,695 


4,715 


-20 


-0.4 


20-24 


11,894 


11,880 


14 


0.1 


25-29 


18,436 


18,484 


-48 


-0.3 


30-34 


26,829 


27,163 


-334 


-1.2 


35-39 


14,889 


15,121 


-232 


-1.5 


40-44 


3,260 


3,085 


175 


5.7 


>45 


159 


175 


-16 


-9.1 



BIRTHS BY CESAREAN SECTION 

The number of Cesarean section deliveries in Massachusetts increased from 22,947 in 2002 
to 23,860 in 2003, an increase of about 4.0%. Cesarean section was the method of delivery 
for 28.2% of the 2002 occurrence births, compared to the 29.5% of Cesarean section 
deliveries in 2003. (Calculations are based on births with known method of delivery.) 



25 



LOW BIRTHWEIGHT INFANTS 



The percentage of low birthweight infants (less than 2,500 grams or five pounds eight 
ounces) increased slightly from 7.5% in 2002 to 7.6% in 2003. The number of low 
birthweight deliveries decreased from 6,127 births in 2002 to 6,115 births in 2003. 

HOSPITAL PROFILES 

The following is a synopsis of hospital data, some of which is presented in Table B-13: . 

• In 2003, 81,309 births occurred in Massachusetts, a decrease of 12.5% since 1990. 
Cesarean section was the method of delivery for 29.5% of 2003 births. (Calculations 
are based on births with known method of delivery.) 

• In 2003, the Cesarean section rate was less than 30% for the tenth consecutive year. 
Five licensed maternity facilities had Cesarean section delivery rates of 35% or 
more: Beth Israel Deaconess Medical Center, North Adams Regional Hospital, Holy 
Family Hospital and Medical Center, Tufts - New England Medical Center Hospital, 
and Caritas St. Elizabeth's Medical Center. 

• Statewide, the lowest rates of Cesarean section deliveries were at the following 
licensed maternity facilities: Tobey Hospital (16.2%), Heywood Memorial Hospital 
(19.6%), Berkshire Medical Center (21.6%), Mercy Medical Center (21.8%), Brockton 
Hospital (29.9%), and Leominster Hospital (24.1%). 

• In 2003, at least 10% of the births in six licensed maternity facilities were low 
birthweight. These facilities were: Baystate Medical Center, Beth Israel Deaconess 
Medical Center, Massachusetts General Hospital, UMass Memorial Medical Center - 
West Campus, Caritas St. Elizabeth's Medical Center, and Tufts- New England 
Medical Center Hospital. 

• In eight facilities, 50% or more of the deliveries were paid with public funds: Boston 
Medical Center, Cambridge Hospital, Mary Lane Hospital, Brockton Hospital, Mercy 
Medical Center, Holyoke Hospital, St. Luke's Hospital, and Lawrence General 
Hospital. In five facilities, less than 10% of deliveries were paid with public funds: 
Emerson Hospital, Newton-Wellesley Hospital, South Shore Hospital, The Birthplace 
at Wellesley, and Winchester Hospital. 

■ In 2003, 25 of the 52 licensed maternity facilities exceeded the state-wide average 
(84.5%) for adequacy of prenatal care for their patients. The three maternity facilities 
with the lowest reported rate of women who had received adequate prenatal care 
were: Boston Medical Center (52.3%), Berkshire Medical Center (56.1%), and Tobey 
Hospital (52.9%). 



26 



DEFINITIONS IMPORTANT FOR THIS SECTION INCLUDE: 
ADEQUACY OF PRENATAL CARE UTILIZATION 



Beginning in 2001, adequacy of prenatal care is being measured using a new method. The 
Adequacy of Prenatal Care Utilization (APNCU) Index, developed by Dr. Milton Kotelchuck, 
replaced the Ressner Index. The APNCU Index is the standard used in Healthy People 
2010 and by the majority of states. It improves upon the Kessner Index in various ways, 
the most important being the ability to distinguish between inadequate prenatal care due to 
the timing of initiation and inadequate care due to insufficient prenatal care visits. The 
APNCU Index also improves upon the Kessner Index by correcting some of its principal 
limitations. First, the APNCU Index more accurately assesses adequacy of visits for term 
pregnancies; the Kessner Index characterizes 9 or more visits as adequate, due to an early 
computer database limitation, which only allowed for a single-digit number to record 
prenatal care visits. Other limitations of the Kessner Index include its bias towards 
measurement of adequacy of initiation of care, and its various computational algorithms 
based upon inadequate initial documentation. 

Below are the definitions for the APNCU Index categories and its two component indices 
(initiation and received services), and the definition of the Kessner Index categories. 
Following that is a short summary of the major differences in classification of adequacy of 
prenatal care using the Kessner Index and the APNCU Index. 

Adequacy of Prenatal Care Utilization (APNCU) Index: Definition of Categories 



Category 


Month Prenatal Care 
Began 


% of Expected 1 
Prenatal Care 


Adequate Intensive 


1, 2, 3, or 4 


110% or more 


Adequate Basic 


1, 2, 3, or 4 


80 - 109% 


Intermediate 


1, 2, 3, or 4 


50 - 79% 


Inadequate 


Month 5 or later 


Less than 50% 


Unknown 


Prenatal care information not recorded 



1 . The number of "expected" visits is determined based on standards set by the American 
College of Obstetricians and Gynecologists (ACOG). 



27 



Component Indices of the APNCU Index: Definitions of Categories 



Adequacy of Initiation Index 



Category 


Month Prenatal Care Began 


Adequate Intensive 


1 or 2 


Adequate Basic 


3 or 4 


Intermediate 


5 or 6 


Inadequate 


Month 7 or later, or no PNC 


Unknown 


Prenatal care initiation information not recorded 


Adequacy of Received Services (Visits) Index 


Category 


% of Expected 1 Prenatal Care Visits 


Adequate Intensive 


1 10% or more 


Adequate Basic 


80 - 109% 


Intermediate 


50 - 79% 


Inadequate 


Less than 50% 


Unknown 


Information on prenatal care visits not recorded 



1. The number of "expected" visits is determined based on standards set by the American 
College of Obstetricians and Gynecologists (ACOG). 

Kessner Index of Adequacy of Prenatal Care: Definition of Categories 



Category 


Trimester Care Began 


Number of Visits 


Adequate 


1 


9 or more 


Intermediate 


1 


5-8 




2 


5 or more 


Inadequate 


1 


1-4 




2 


1-4 




3 


1 or more 


No Prenatal 







Unknown 


Unknown 


Unknown 



28 



Summary of Major Differences in Categorization of Adequacy of Prenatal Care between the 



Kessner Index and the APNCU Index 



The two different methods used in the Kessner Index and APNCU Index to calculate 
adequacy of prenatal care can result in differences in how each one classifies adequacy of 
prenatal care. These differences only occur under certain conditions, not in all cases (see 
"Explanation" column). 



The Kessner Index 
classifies prenatal care 
as... 


... but the APNCU Index 
classifies prenatal care as ... 


Explanation 


Intermediate 


Adequate Basic 


This is primarily due to the fact that 
the APNCU Index allows for prenatal 
care in the 4 th month of pregnancy 
to be considered adequate if the 
mother received 80-109% of 
expected visits, whereas the 
Kessner Index only allows for care 
begun in the first trimester (months 
1-3) to be considered adequate. 


Intermediate 


Inadequate 


This is primarily due to the fact that 
the APNCU categorizes any prenatal 
care beginning after month 4 as 
"inadequate" whereas the Kessner 
Index allows for care beginning in 
months 5 or 6 with 5 or more visits 
to be "intermediate." 


Adequate 


Intermediate 


This is primarily due to the 
consideration of "expected" visits 
(based on when the mother initiated 
care and the length of gestation) 
using the APNCU Index, which 
bases expected visits on the ACOG 
recommendations, which can be as 
high as 14 visits if a gestational 
period is 40 weeks, whereas the 
Kessner Index considers 9 visits 
sufficient in all cases. 


Adequate 


Adequate Intensive 


The APNCU Index added an 
"Adequate Intensive" category, 
which is not used in the Kessner 
Index. This allows analysis of 
situations in which more than 
normal care is received (e.g. women 
with high risk conditions, pregnancy 
complications). 



29 



ANCESTRY 



A self-reported item on the birth certificate, with listings and an open text field. The items 
listed are: 
Puerto Rican 
Dominican 
Mexican 
Cuban 
Columbian 
Salvadorian 
Other Central Amer. 
Other South Amer. 
Other Hispanic 
Chinese 



Cambodian 

Asian Indian 

Korean 

Filipino 

Japanese 

Laotian 

Pakistani 

Thai 

Hawaiian 

Other Asian/Pac. Isl. 



Cape Verdean 

Brazilian 

Other Potuguese 

Haitian 

Jamaican 

Barbadian 

African American 

Nigerian 



Other African 
Lebanese 
Iranian 
Israeli 

Other Mid. Eastern 
Native American 
European 
Other 



Other West Indian / Caribbean 



BIRTH CERTIFICATE 



A vital record signed by a certifier that includes the infant's name, sex, birth date, place of 
residence, and place of occurrence. 

BIRTHWEIGHT 

The weight of an infant recorded at the time of delivery. It may be recorded in either 
pounds/ounces or grams. If recorded in pounds/ounces, it is converted to grams for use in 
this report. 

1 pound = 453.6 grams 

1,000 grams = 2 pounds, 3 ounces 



BIRTHWEIGHT CATEGORIES 



Normal birthweight (NBW) 



Low birthweight (LBW) 



Very low birthweight (VLBW) 



An infant's weight of 2,500 grams (5.5 
pounds) or more recorded at birth. 

An infant's weight of less than 2,500 grams 
(5.5 pounds) recorded at birth. 

An infant's weight of less than 1,500 grams 
(3.3 pounds) recorded at birth. 



CESAREAN SECTION or C-SECTION 



Primary: A mother's first Cesarean section delivery. 

Repeat: A Cesarean delivery that has been preceded by at least one Cesarean delivery. 



COMMUNITY HEALTH NETWORK AREAS (CHNA) 

The Department of Public Health, in collaboration with health service providers, coalition 
members, and other interested citizens, has designated 27 geographic areas for 
community health planning. The Department of Public Health has fostered in each of these 



30 



areas the development of Community Health Networks: a consortia of health care 
providers, human service agencies, schools, churches, youth, parents, elders, advocacy 
groups, and individual consumers to address the health needs of the community. These 
community coalitions will participate in monitoring outcomes and the progress of 
strategies and responses to those health needs. The data published in this edition reflect 
the new definitions of CHNAs instituted in January 1997. 

A Community Health Network Area (CHNA) is defined as an aggregation of cities and 
towns. It is hoped that the networks will mobilize around key health issues impacting the 
community, promote prevention efforts, enhance access to health care, provide 
opportunities for more collaboration among agencies, and create a client-centered, 
outcome-oriented health service delivery system. Community Health Networks will also 
promote efficiency in service delivery by working to reduce duplication and overlap, and by 
identifying gaps in service. 

ETHNICITY 

See Race. 

FOREIGN-BORN WOMEN 

Women not born in the United States, its possessions or protectorates. Women born in 
Puerto Rico, the US Virgin Islands, and Guam are not foreign-born. 

HEALTHY START 

A Massachusetts-funded program providing services and financing for prenatal care to 
low-income pregnant women who lack health insurance, but do not qualify for Medicaid. 

INFANT 

A child whose age is less than one year (365 days). 
LIVE BIRTH 

A live birth is any infant who breathes or shows any other evidence of life (such as beating 
of the heart, pulsation of the umbilical cord, or definite movement of voluntary muscles) 
after separation from the mother's uterus, regardless of the duration of gestation. 

LOW BIRTHWEIGHT (LBW) 

See Birthweight Categories. 

NEONATAL 

Referring to a child under 28 days of age. 
NORMAL BIRTHWEIGHT (NBW) 
See Birthweight Categories. 



31 



OCCURRENCE BIRTH 



A birth occurring in the Commonwealth of Massachusetts, regardless of the residency of 
the mother. In Massachusetts, the place will be one of the 351 cities or towns. See Resident 
Birth. 

PARITY 

Total number of live births, including the present birth, ever born to the mother. 
PLURALITY 

The number of births to a woman produced in the same gestational period. A singleton is 
the birth of one infant, twins represent the births of two infants, etc. 

POST-NEONATAL 

Referring to a child whose age is at least 28 days, but less than one year. 
PRIMARY CESAREAN SECTION or C-SECTION 
See Cesarean Section. 
RACE 

Race of mother: For data presented in this publication, mother's race is as reported by the 
infant's mother. The tables that use race or ethnicity in this document all refer to the 
mother's race or ethnicity. 

Ethnicity: Beginning in 1986, an identifier for Hispanic and other ethnicities was added to 
the birth certificate. Prior to this change, most Hispanics were included with Whites and it 
was not possible to accurately calculate Hispanic-specific rates of natality. 

REPEAT CESAREAN SECTION or C-SECTION 

See Cesarean Section. 

RESIDENT BIRTH 

The birth of an infant whose mother reports that her usual place of residence is in 
Massachusetts. In Massachusetts, a resident is a person with a permanent address in one 
of the 351 cities or towns. Vital statistics data may be presented in terms either of 
residence or occurrence. Unless otherwise noted, all data in this publication are resident 
data. Resident data include all events that occur to residents of the Commonwealth, 
wherever they occur. Occurrence data include all events that occur within the state, 
whether to residents or non-residents. There is an exchange agreement among the 50 
states, Canada, Puerto Rico, Guam, the Virgin Islands, and the District of Columbia that 
provides for exchange of copies of birth and death records. These records are used for 
statistical purposes only, and allow each state or province to track the births and deaths of 
its residents. 



32 



states, Canada, Puerto Rico, Guam, the Virgin islands, and the District of Columbia that 
provides for exchange of copies of birth and death records. These records are used for 
statistical purposes only, and allow each state or province to track the births and deaths of 
its residents. 

VAGINAL BIRTH AFTER CESAREAN (VBAC) 

A vaginal delivery of an infant to a mother who has had at least one prior Cesarean section 
delivery. 

VERY LOW BIRTHWEIGHT (VLBW) 
See Birthweight Categories. 

RATES IMPORTANT FOR THIS SECTION INCLUDE: 

No. of Resident Live Births for a 
Specific Age Group of Mothers x 1,000 
Total Female Population of That 
Specific Age Group 

No. of Resident Live Births x 1,000 
Total Resident Population 

No. of Resident Live Births x 1,000 
Total Female Population of 
Childbearing Age (15-44) 

No. of Resident Births Delivered by C-Section x 100 
Total Number of Resident Births 



AGE-SPECIFIC BIRTH RATE 

CRUDE BIRTH RATE 

GENERAL FERTILITY RATE 

CESAREAN SECTION or 
C-SECTION RATE 



33 



Figure B-1 . Daily Birth Statistics, Massachusetts: 2003 

Every day in 2003, residents of Massachusetts experienced an average of: 




220 Births 



64 Births by Cesarean Section 



50 Births to women aged 35 or older 



38 Births with less than adequate 



prenatal care 




17 Births weighing less than 2500 grams 
or 5 lbs. 8 oz. (low birthweight) 

13 Births to women aged 15 through 19 



34 



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3,790 
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6,916 
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3,664 
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87,202 
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76,052 
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7,203 
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3,582 
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88,176 
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76,983 
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7.352 
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3,566 
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92,461 
62.1 


80,775 
87.4 


7.729 
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3,688 
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72,591 
53.4 


66,220 
91.2 


4,626 
6.4 


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22.262 
27.8 


6.115 
7.6 


6,963 
8.7 


79.9 


4,642 
22.6 


21.604 
26.8 


6.060 
7.5 


6,795 
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79.9 
84.7 


4,979 
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21.620 
26.7 


5,795 
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6,412 
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80.4 
85.2 


5,305 
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21,621 
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6,582 
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79.1 
83.3 


5,515 
26.7 


21,448 

26.5 


5.708 
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6,136 
7.6 


79.4 
82.9 


5,823 
28.1 


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43 



Table B-4. Age-Specific and Crude Birth Rates, Massachusetts: 1990 and 2003 
1990 2003 

Percent Change 



Mother's Age 


Births 1 


Rate 


Births 


Rate 2 


in Rate 


12-14 


124 


1.3 


56 


0.4 


-69.2 


15-19 


7,258 


35.1 


4.639 


22.6 


-35.6 


20-24 


18,115 


69.5 


11,894 


57.9 


-16.7 


25-29 


29,913 


107.2 


18,436 


83.6 


-22.0 


3U-J4 








■1 f\7 O 


14. Z 


35-39 


9,795 


40.1 


14,889 


54.3 


35.4 


40-44 


1,522 


6.9 


3,260 


12.2 


76.8 


45 + 3 


46 


0.3 


159 


0.7 


133.3 


Birth rate, ages 
15-44 4 


92,290 


62.2 


79,947 


56.2 


-9.6 


Crude Birth 
Rate 5 


92,461 


15.4 


80,167 


12.6 


-18.2 



NOTE: All percentages are calculated based on only those births with known values for the characteristic(s) of interest, unless 
otherwise stated. 

1 . Differences in the number of births from previous publications are the result of updated birth files. The number of births for all age 
groups does not always add to the total number of births as mother's age is sometimes not recorded on the birth certificate. 2. 
2003 birth rates are calculated using DPH 2000 population estimates, based on U.S. Census 2000 population counts. 3. Denominator 
is female population ages 45-49. 4. Rate represents the total number of births to women ages 15-44 per 1,000 women. 5. Births per 
1 ,000 residents (male and female). Includes births to mothers of all age groups and mothers for whom age is unknown. 



44 



Figure B-4. Trends in the number of Births by Mother's Age 
Group, Massachusetts: 1980-2003 



60,000 T 




o.ooo -• 



-I 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 

680 681 682 "B83 684 685 686 687 688 689 690 691 692 693 694 695 696 697 698 699 2000 2001 2002 2003 



Year 



45 



Figure B-5. Percent of Mothers Breastfeeding or intending to Breastfeed 1 by 




10-14 15-19 20-24 25-29 30-34 35-39 40-44 45+ Total 

Age Group of Mother (in years) 



NOTE: All percentages are calculated based on only those births with known values for the characteristic(s) of interest, unless 
otherwise stated. 

1. Information about breastfeeding is reported by the mother at the time of birth. 

2. For race-specific breastfeeding rates see Table B2A. 



46 



Figure B-6. Percent of Mothers who Smoked During Pregnancy 1 
by Mother's Race/Hispanic Ethnicity and Educational Attainment, 

Massachusetts: 2003 



50 
40 
30 
20 
10 




Massachusetts Total 



20.3 



J 13.9 
I ■ 



Less than Hgh School Some 
High School Graduate College 



1.2 



0.5 



College More than 
Graduate College 



7.7 



TOTAL 



50 
40 
30 
20 
10 



50 
40 
30 
20 
10 




38.3 

II 


White non-Hispanic 
18.7 

9.5 

■ _■ " 


8.6 


Less than 


Hgh Some 


College 


TOTAL 


High School College 


Grad or 




School Graduate 


More 






Hs panic 






9.6 










4.5 4.7 




5.9 






0.6 




Less than Hgh Some 
Hgh School College 
School Graduate 


College 
Grad or 
More 


TOTAL 



CL 



50 
40 
30 
20 
10 




Black non-Hs panic 



15.7 



8.4 



50 
40 
30 
20 
10 




5.2 



2.7 



4.2 



6.5 



0.6 



Less than Hgh Some 
Hgh School College 
School Graduate 



College 
Grad or 
More 



TOTAL 



Asian 



1.0 



0.3 



Less than Hgh Some College 
Hgh School College Grad or 
School Graduate More 



1.4 



TOTAL 



NOTE: All percentages are calculated based on only those births with known values for the characteristic(s) of interest, unless otherwise stated. 

1 . Based on information provided on parent worksheet. Due to self-reported nature, data on smoking prevalence should be interpreted cautiously. Mothers 
with more than one delivery are counted for each birth. Note: Caution should be used with Asian data because of small numbers. 



47 



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48 



Table B-5A. Parity 1 by Age of Mother, Massachusetts: 2003 



Age of Mother (years) 


Total Births 


1 st Birth 


2 nd Birth 


3 rd Birth 


4 th Birth 


5* + Birth 


STATE TOTAL 


n 2 


80,167 


35,286 


27,800 


11,448 


3,619 


1,806 




% 3 


100.0 


44.1 


34.8 


14.3 


4.5 


2.3 


10-14 


n 


56 


56 
















% 


100.0 


100.0 


0.0 


0.0 


0.0 


0.0 


15-19 


n 


4,639 


3,950 


603 


68 


5 







% 


100.0 


85.4 


13.0 


1.5 


0.1 


0.0 


20-24 


n 


11,894 


6,662 


3,741 


1,143 


250 


61 




% 


100.0 


56.2 


31.6 


9.6 


2.1 


0.5 


25-29 


n 


18,436 


9,045 


5,911 


2,379 


713 


343 




% 


100.0 


49.2 


32.1 


12.9 


3.9 


1.9 


30-34 


n 


26,829 


10,390 


10,564 


3,979 


1,258 


570 




% 


100.0 


38.8 


39.5 


14.9 


4.7 


2.1 


35-39 


n 


14,889 


4,216 


5,787 


3,214 


1,067 


571 




% 


100.0 


28.4 


39.0 


21.6 


7.2 


3.8 


40-44 


n 


3,260 


911 


1,142 


637 


316 


244 




% 


100.0 


28.0 


35.1 


19.6 


9.7 


7.5 


45+ 


n 


159 


53 


51 


28 


10 


17 




% 


100.0 


33.3 


32.1 


17.6 


6.3 


10.7 



NOTE: All percentages are calculated based on only those births with known values for the characteristic(s) of 
interest, unless otherwise stated. 



1. The number of live births including this birth. 2. State totals include births of unknown parity and unknown 
mother's age. Note: Percents may not sum to 100.0 due to rounding. 



Table B-5B. Trends in Number and Percent Distribution of Births 1 by Plurality and Age, 

Massachusetts: 1990-2003 



Singletons 


Multiples 2 


Total b 


irths 

% .. 


Age 
Group Year 


n 


% 


Twins 


Triplets or more 


Total Multiples 


n 


n 


% 


n 


% 


n 


% 


All A 

All Aqes 






















1990 


90,049 


97,4 


2,312 


2.5 


99 


0.1 


2,411 


2.6 


92,460 


100.0 


1991 


85,802 


97.3 


2,285 


2.6 


89 


0.1 


2,374 


2.7 


88,176 


100.0 


1992 


84,722 


97.2 


2,347 


2.7 


133 


0.2 


2,480 


2.8 


87,202 


100.0 


1993 


82,055 


97.0 


2,367 


2.8 


205 


0.2 


2,572 


3.0 


84,627 


100.0 


1994 


81,187 


96.9 


2,357 


2.8 


214 


0.3 


2,571 


3.1 


83,758 


100.0 


1995 


78,935 


96.8 


2,429 


3.0 


198 


0.2 


2,627 


3.2 


81,562 


100.0 


1996 


77,355 


96.5 


9 fi91 


O.O 


1 QA 

1 »4 




9 Q 1 K 


O.O 


80,164 


100.0 


1997 


77,203 


96.1 


9 ft^fi 


O.U 


9fi9 


n ^ 

u.o 


^ 1 1ft 
O, 1 1 O 


o.y 


80,321 


100.0 


1998 


78,004 


95.8 


1 1 14 

O, 1 1 H 


^ ft 

O.O 


9ftft 

LOO 


n 4 

U.H 


^ 409 


4 9 


81,406 


100.0 


1999 


77,473 


95.8 


O, l*tf 


O.C7 


94R 


n *3 
u.o 


0,030 


4 9 


80,866 


100.0 


2000 


78,075 


95.7 




4 


■ 944 


n ^ 
u.o 


o,ou/ 


4 ^ 


81,582 


100.0 


2001 


.77,409 


95.6 


^ T71 

0,01 I 


4 9 


ZOH 


u.o 


o.ouo 


4 4 


81,014 


100.0 


2002 


76,673 


95.1 


^ 70A 
O, / uo 


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H.O 


94 


u.o 


o,yo i 


4 Q 

4.y 


80,624 


100.0 


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76,367 


95.3 


O.OOl 


A A 
4.4 


OA Q 
Z4» 


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o.ouu 


4. / 


80,167 


100.0 


Aqes <35 






















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79,081 


97.5 


1,946 


2.4 


70 


0.1 


2,016 


2.5 


81,097 


100.0 


1991 


74,810 


97.5 


1,863 


2.4 


76 


0.1 


1,939 


2.5 


76,749 


100.0 


1992 


73,043 


97.3 


1,914 


2.6 


103 


0.1 


2,017 


2.7 


75,060 


100.0 


1993 


70,042 


97.2 


1,849 


2.6 


158 


0.2 


2,007 


2.8 


72,049 


100.0 


1994 


68,644 


97.2 


1,844 


2.6 


164 


0.2 


2,008 


2.8 


70,652 


100.0 


1995 


ec acta 


iii.Z 


1,787 


2.6 


141 


0.2 


1,928 


2.9 


67,597 


100.0 




63 560 


Qfi Q 


1,935 


2.9 


126 


0.2 


2 r 061 


3.1 




TJU.u 


1997 


62,598 


96.7 


1,949 


3.0 


170 


0.3 


2,119 


3.3 


fi4 717 


100 


1998 


62,719 


96.4 


2,193 


3.4 


170 


0.3 


2,363 


3.6 


65,082 


100.0 


1999 


61,816 


96.4 


2,147 


3.3 


150 


0.2 


2,297 


3.6 


64,113 


100.0 


2000 


61,659 


96.4 


2,205 


3.4 


130 


0.2 


2,335 


3.6 


63,994 


100.0 


2001 


60,704 


96.3 


2,211 


3.5 


134 


0.2 


2,345 


3.7 


63,049 


100.0 


2002 


59,736 


96.0 


2,379 


3.8 


127 


0.2 


2,506 


4.0 


62,242 


100.0 


2003 


59,347 


95.9 


9 7ftQ 


^ Q 

o.y 


I I o 


n 9 




4 1 
4. I 


61,854 


100.0 


Aqes 35+ 






















1990 


10,968 


96.5 


366 


3.2 


29 


0.3 


395 


3.5 


11,363 


100.0 


1991 


10,987' 


96.2 


422 


3.7 


13 


0.1 


435 


3.8 


11,422 


100.0 


1992 


11,675 


96.2 


433 


3.6 


30 


0.3 


463 


3.8 


12,138 


100.0 


1993 


12,007 


95.5 


518 


4.1 


47 


0.4 


565 


4.5 


12,572 


100.0 


1994 


12,543 


95.7 


513 


3.9 


50 


0.4 


563 


4.3 


13,106 


100.0 


1995 


13,264 


95.0 


642 


4.6 


57 


0.4 


699 


5.0 


13,963 


100.0 


1996 


13,793 


94.8 


686 


4.7 


68 


0.5 


754 


5.2 


14,547 


100.0 


1997 


14,602 


93.6 


907 


5.8 


92 


0.6 


999 


6.4 


15,601 


100.0 


1998 


15,282 


93.6 


921 


5.6 


118 


0.7 


1,039 


6.4 


16,321 


1U0.U 


1999 


15.657 


93.5 


1,000 


6.0 


96 


0.6 


1,096 


6.5 


16,753 


100.0 


2000 


16,412 


93.3 


1,058 


6.0 


114 


0.6 


1,172 


6.7 


. 17,584 


100.0 


2001 


16,703 


93.0 


1,160 


6.5 


100 


0.6 


1,260 


7.0 


17,963 


100.0 


2002 


16,936 


92.1 


1,329 


7.2 


116 


0.6 


1,445 


7.9 


18,381 


100.0 


2003 


17,015 


92.9 


1,162 


6.3 


131 


0.7 


1,293 


7.1 


18,308 


100.0 



NOTE: All percentages are calculated based on only those births with known values for the characteristic's) of interest, unless otherwise stated. 
1 . Differences in the number of births from previous publications are the result of updated of files. 2. Numbers of multiples (n) represent individual 
infants rather than sets of infants. 



50 



Table B-6. Selected Birth Characteristics by Maternal Education, Massachusetts: 2003 





Less than Hiqh 
School 

n % 1 


Hiqh School 
Graduate 

n %' 


Some College 
n %' 


Colleqe 
Graduate 

n %' 


More than 
Colleqe 

n "/o 1 


State Total 


7,915 


9.9 


19,762 


24.7 


17,944 


22.4 


21,484 


26.9 


12,882 


16.1 


Race 






















White non-Hispanic 


2.856 


5.0 


12,434 


21.6 


13,189 


22.9 


18.258 


31.7 


10,818 


18.8 


Black non-Hispanic 


753 


12.8 


2,113 


35.8 


1,937 


32.8 


800 


13.6 


294 


5.0 


Hispanic 


3,353 


34.4 


3,642 


37.3 


1,762 


18.1 


690 


7 i 


O 1 sJ 




Asian 


667 


12.8 


1,019 


19.5 


721 


13.8 


1,539 


29 5 


1 ?76 


?4 4 


Age 






















20-29 


3,723 


12.3 


10,660 


35.2 


8,230 


27.2 


5,546 


18 3 


9 117 

C. , 1 1 / 


7 n 


30-39 


1,478 


3.6 


6,752 


16.2 


8,730 


21.0 


14,751 


35.4 


9,903 


23.8 


40+ 


138 


4.1 


551 


16.2 


693 


20.3 


1,165 


34.2 


860 


25.2 


Non-U.S.-born 2 


3,130 


39.6 


5,850 


29.6 


3,664 


20.4 


3,929 


18.3 


2,752 


21.4 


Unmarried 


5,762 


72.8 


9,458 


47.9 


5,144 


28.7 


1,414 


6.6 


433 


3.4 


Publicly-financed prenatal care 


6,230 


80.0 


10,093 


52.1 


4,756 


26.9 


1,286 


6.1 


291 


2.3 


Very low birthweight 3 


124 


1.6 


313 


1.6 


251 


1.4 


285 


1.3 


131 


1.0 


Low birthweight 4 


736 


9.3 


1,645 


8.3 


1,330 


7.4 


1,517 


7.1 


868 


6.7 


Adequate prenatal care 5 


5,517 


70.7 


15,824 


80.9 


15,155 


85.1 


18,990 


88.8 


11,591 


90.4 


Cesarean section delivery 


1,761 


22.4 


5,541 


28.2 


5,554 


31.1 


6,574 


30.7 


3,922 


30.5 


Breastfeeding 6 


4,900 


62.5 


13,248 


68.1 


13,312 


75.3 


18,341 


87.3 


11,518 


92.0 


Multiple births 


164 


2.1 


712 


3.6 


864 


4.8 


1,286 


6.0 


770 


6.0 


Smoking During pregnancy 


1,609 


20.3 


2,746 


13.9 


1,451 


8.1 


254 


1.2 


58 


0.5 



NOTE: Ail percentages are calculated based on only those births with known values for the characteristic(s) of interest, unless otherwise stated. 



1 . For state total, race and age categories, percentages are based on row totals. For all other categories, percentages are based on state column totals. 2. Includes women 
bom outside of the 50 U.S. States, Washington DC, and Puerto Rico/U.S. territories (the U.S. Virgin Islands, and Guam). 3. Very low birthweight: less than 1.500 grams or 
3.3 pounds. 4. Low birthweight: less than 2,500 grams or 5.5 pounds. 5. Beginning with the 2001 publication, the Adequacy of Prenatal Care Utilization Index has replaced 
the Kessner Index as the measure of adequate prenatal care. 6. Mother was breastfeeding or was intending to breastfeed at the time the birth certificate was completed. 



51 



Table B-7A. Interpregnancy Intervals 1 (IPI) and Birth Outcomes. 
Pregnancies to Muciparous 2 Mothers, Massachusetts: 2003 









Birth Weiqht (BW) 




Gestational Aqe (GA) 


IPI 

(months) 


Pregnancies 


Low Birthweight 
(<2,500 g) 

n % LBW 5 


Very Low 
Birthweight 
(<1,500g) 
n % VLBW 


Preterm 3 
(<37 wk) 

n % Preterm 


Very Early 4 
(<28 wk) 

n % VEGA 


State Total 


42,329 


2,162 


5.1 


357 


0.8 


2.773 


6.6 


166 


0.4 


<5 


1,879 


117 


6.2 


27 


1.4 


159 


8.5 


14 


0.7 


6-11 


4,836 


205 


4.2 


34 


0.7 


295 


6.1 


19 


0.4 


12-17 


6,101 


251 


4.1 


36 


0.6 


344 


5.7 


21 


0.3 


18-23 


5,492 


225 


4.1 


28 


0.5 


309 


5.6 


12 


0.2 


24-29 


4,519 


178 


3.9 


24 


0.5 


241 


5.4 


10 


0.2 


30-35 


3,396 


134 


3.9 


17 


0.5 


192 


5.7 


10 


0.3 


36-41 


2,705 


128 


4.7 


20 


0.7 


163 


6.1 


8 


0.3 


42-47 


2,119 


127 


6.0 


18 


0.8 


147 


7.0 


5 


0.2 


48+ 


11,282 


797 


7.1 


153 


1- 4 


923 


8.2 


67 


0.6 


Short < 12 


6,715 


322 


4.8 


61 


0.9 


454 


6.8 


33 


0.5 


12-35 


19,508 


788 


4.0 


105 


0.5 


1,086 


5.6 


53 


0.3 


36+ 


16,106 


1,052 


6.5 


191 


1.2 


1,233 


7.7 


80 


0.5 



1 . Interpregnancy Interval (IPI) is calculated in months between the date of last menstrual period of the cunent pregnancy and the date of 
previous live birth, among pregnancies to multiparous mothers (parity >1). 2. Muciparous is defined as having given birth 2 or more times. 3. 
Also known as premature delivery. 4. Very early gestational age (VEGA) refers to birth delivery before 28 weeks of gestation age and is also 
known as extremely preterm delivery. 5. These are the row percentages, that is. the relevant column N/the row totals. 



52 



Table B-7B. Interpregnancy Interval 1 (IPI) by Maternal Characteristics 
Pregnancies to Muciparous Mothers 2 , Massachusetts: 2003 





Total 
Pregnancies 
Parity >1 


Short 

(< 12 months) 


IE! 

(12-35 months) 


(36+ 


months) 






N 


0/ 

70 


N 


% 


N 


% 


State Total 3 


42,329 


6,715 


15.9% 


19,508 


46.1% 


16,106 


38.0% 


Age 
















<20 


632 


274 


43.4% 


315 


49.8% 


43 


6.8% 


20-34 


29,401 


5,017 


17.1% 


13,810 


47.0% 


10,574 


36.0% 


35+ 


12,296 


1,424 


1 1 .6% 


5,383 


43.8% 


5,489 


44.6% 


Rarp Fthnicitv 
















\A/hitp nnn-Hi^nanir 

V V 1 II 1 Ivl 1 1 1 lOlJul IIL 




4 Qftft 


I O.U /o 


ID, I o / 


OU.I 70 


10,095 


OO AO/ 

33.4% 


Black non-Hi^nanir 






I O.O /o 


1 noft 
i ,uyo 


•DO. I /O 


1 , ( (\ 


CO AO/ 

53.4% 


Hispanic 


5,564 


827 


14.9% 


1,969 


35.4% 


L, f OO 


4Q 7°/„ 


Asian non-Hispanic 


2,430 


341 


14.0% 


1.017 


41.9% 


1,072 


44.1% 


Education 
















High school or less 


15,071 


2,314 


15.4% 


5,529 


36.7% 


7,228 


48.0% 


College or some college 


20,996 


3,351 


16.0% 


10.201 


48.6% 


7,444 


35.5% 


More than college 


6,206 


1,044 


16.8% 


3,751 


60.4% 


1,411 


22.7% 


Delivery Payment Source 
















Public 


12,464 


1,994 


16.0% 


4,484 


36.0% 


5,986 


48.0% 


Private 


28,750 


4,529 


15.8% 


14,493 


50.4% 


9,728 


33.8% 


uunno r\eg ion or rcesiuency 
















Western 


5,131 


853 


16.6% 


2,209 


43.1% 


2,069 


40.3% 


Central 


5.843 


873 


14.9% 


2,702 


46.2% 


2,268 


38.8% 


Northeast 


8,944 


1,426 


15.9% 


4,114 


46.0% 


3,404 


38.1% 


Metrowest 


9,327 


1,553 


16.7% 


4,917 


52.7% 


2,857 


30.6% 


Southeast 


8,226 


1,268 


15.4% 


3.736 


45.4% 


3,222 


39.2% 


Boston 


4,858 


742 


15.3% 


1.830 


37.7% 


2,286 


47.1% 


i own or rcesioency 




10 Larqest bv % 


10 Larqest bv % 


10 Larqest bv % 






Billerica (20.7%) 


Needham (68.8%) 


Chelsea (60.3%) 






Weymouth (20.5%) 


Wellesley (61.1%) 


Revere (51.6%) 






Holyoke (20.5%) 


Arlington (57.7%) 


Lynn (49.8%) 






Quincy (19.8%) 


Natick (57.5%) 


Fall River (49.7%) 






Natick (19.4%) 


Chelmsford (57.4%) 


Everett (49.6%) 






Westfield (19.3%) 


Franklin (56.6%) 


Maiden (49.6%) 






Dracut (18.9%) 


Brookline (56.2%) 


Lawrence (48.8%) 






Springfield (18.6%) 


Braintree (54.9%) 


Brockton (48.8%) 






Lowell (18.6%) 


Mansfield (52.8%) 


New Bedford (48.0%) 






Methuen (18.4%) 


Shrewsbury (52.2%) 


Randolph (47.2%) 



1 . See Table B-7A. 2. Multiparous is defined as having given birth 2 or more times. 3. State total includes pregnancies with known IPI. 4. 
Among towns with at least 200 mothers giving birth to their 2nd or later child. 



53 



Figure B-8. Low Birthweight 1 Among Smoking and Nonsmoking 2 
Mothers by Race and Hispanic Ethnicity, Massachusetts: 2003 



r 



c 
u 

4> 
Q. 




White 



■ Smokers 
□ Non-Smokers 



Hon- Black Non- Hispanic Asian 
Hispanic Hispanic 



11.5 




Massachusetts 
Total 



Race and Hispanic Ethnicity 



NOTE: All percentages are calculated based on only those births with known values for the characteristics) of interest, unless otherwise 
stated. Maternal smoking is self-reported, usually following childbirth; these data should be interpreted cautiously. 

1. Low birthweight: less than 2.500 grams or 5.5 pounds. 

2. Based on information provided on the parent worksheet for birth certificates 



54 



Table B-8. Summary of Selected Teen Birth Characteristics, Massachusetts: 2003 





Age 15-17 


Age 18-19 


Combined Ages 15-19 




N 


% 1 


N 


% 1 


N 


% 1 


State total 


1,473 


31.8% 


3,166 


68.2% 


4,639 


100.0% 




Maternal Demographics 


Race/Hispanic Ethnicity 


N 


% 2 


N 


% 2 


N 


% 2 


White non-Hispanic 


581 


39.5% 


1,630 


51.5% 


2,211 


47.7% 


Black non-Hispanic 


190 


12.9% 


356 


11.3% 


546 


11.8% 


Asian 


67 


4.6% 


113 


3.6% 


180 


3.9% 


Hispanic 


588 


40.0% 


962 


30.4% 


1,550 


33.5% 


Other 


45 


3.1% 


101 


3.2% 


146 


3.2% 


Birthplace 


U.S. States / D.C. 


1,130 


76.8% 


2,402 


75.9% 


3,532 


76.2% 


Puerto Rico / US Terr. 


149 


10.1% 


239 


7.6% 


388 


8.4% 


Non-U.S.-born 


192 


13.1% 


523 


16.5% 


715 


15.4% 


Prenatal care funding 


Public 


1,049 


72.8% 


2,374 


76.4% 


3,423 


75.3% 


Private, other 


392 


27.2% 


732 


23.6% 


1,124 


24.7% 


Pregnancy-Related Factors 

Adequacy of Prenatal Care 3 


Adequate Total 4 


1,001 


68.9% 


2,306 


73.8% 


3,307 


72.2% 


Adequate Intensive 


481 


33.1% 


1,076 


34.4% 


1,557 


34.0% 


Adequate Basic 


520 


35.8% 


1,230 


39.3% 


1,750 


38.2% 


Intermediate 


144 


9.9% 


285 


9.1% 


429 


9.4% 


Inadequate/None 


307 


21.1% 


535 


17.1% 


842 


18.4% 


Unknown 


21 


1.4% 


40 


1.3% 


61 


1.3% 


Parity 6 


1 


1,360 


92.7% 


2,590 


82.0% 


3,950 


85.4% 


2 


104 


7.1% 


499 


15.8% 


603 


13.0% 


3+ 


3 




70 


2.2% 


73 


1.6% 


Smoking during Pregnancy 


Yes 


202 


13.7% 


576 


18.2% 


778 


16.8% 


No 


1,268 


86.3% 


2,585 


81.8% 


3,853 


83.2% 


Birth Outcomes 

Birthweight 


< 500 g 


6 


0.4% 


7 


0.2% 


13 


0.3% 


500-1 ,499 g 


26 


1.8% 


46 


1.5% 


72 


1.6% 


1,500-2,499 g 


130 


8.9% 


213 


6.7% 


343 


7.4% 


LBW{<2,499 g) 


162 


11.1% 


266 


8.0% 


428 


9.3% 


2,500-3,999 g 


1,245 


84.9% 


2,715 


85.9% 


3,960 


85.6% 


4000+ g 


60 


4.1% 


178 


5.6% 


238 


5.1% 


Gestational age 


< 28 weeks 


20 


1.4% 


27 


0.9% 


47 


1.0% 


< 37 weeks 


128 


8.8% 


247 


7.9% 


375 


8.2% 


37-42 weeks 


1,298 


89.7% 


2,853 


91.2% 


4,151 


90.8% 


43+ weeks 


1 


_5 





0.0% 


1 


5 


Plurality 


Singleton 


1,455 


98.8% 


3,118 


98.5% 


4,573 


98.6% 


Multiple birth 


18 


1 .2% 


48 


1 .5% 


66 


1.4% 



NOTE: All percentages are calculated based on only those births with known values for the characteristic(s) of interest, unless otherwise stated. 
1. For state total row, percentages are based on total births to women ages 15-19. For the rest of the table, percentages are based on all births for a given 
age group and characteristic. 2. Percents are based on state total of the age group. 3. Based on Adequacy of Prenatal Care Utilization (APNCU) Index. 4. 
Adequate Total = Adequate Basic + Adeq Intensive 5. Calculations based on fewer than five events are excluded. 6. Number of live births including the 
current birth 



55 



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59 



Figure B-10. Adequacy of Prenatal Care for Selected Population 
Characteristics, Massachusetts: 2003 




0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% 
Percent of Mothers with Adequate Prenatal Care 1 



NOTE: All percentages are calculated based on only those births with known values for the characteristic(s) of interest, unless 
otherwise stated. Characteristics of interest are not mutually exclusive, except as noted. 



1 . Based on the Adequacy of Prenatal Care Utilization (APNCU) Index. 2. Women 20 years of age and older. 3. Marital status at 
time of birth. 4. Non-U.S.-born includes women bom outside of the 50 U.S. states, District of Columbia, and U.S. territories 
(Puerto Rico, U.S. Virgin Islands, Guam). 5. Mother was or was intending to breastfeed at the time the birth certificate was 
completed. 



60 



Figure B-1 1 . Trends in Adequacy of Prenatal 
Hispanic Ethnicity, Massachusetts: 



Care 1 by Race and 
1996-2003 



90 T 




70-+^- 1 1 1 1 1 1 1 

1996 1997 1998 1999 2000 2001 2002 2003 

Year 



PLEASE NOTE THAT THE VERTICAL SCALE OF GRAPH REPRESENTS A SMALL INTERVAL (from 70% to 90%) FOR PURPOSES OF 
VISUAL REPRESENTATION. 

NOTE: All percentages are calculated based on only those births with known values for the characteristic(s) of interest, unless otherwise stated 
f. Based on the Adequacy of Prenatal Care Utilization (APNCU) Index. 



61 



Table B-11. Adequacy of Prenatal Care 1 by Selected Characteristics, Massachusetts: 2003 




Adequate Total 2 


Adequate 
Intensive 


Adequate Basic 


Intermediate 


Inadequate 


Unknown 




n 


% 


n 


% 


n 


% 


n 


% 


n 


% 


n 


State Total 


67,173 


84.5% 


31,787 


40.0% 


35,386 


44.5% 


6,119 


7.7% 


6,203 


7.8% 


672 


Age 


Maternal Demoqraphics 


<18 


1,029 


68.3% 


495 


32.8% 


534 


35.4% 


150 10.0% 


328 


21.8% 


22 


18-19 


2,306 


73.8% 


1.076 


34.4% 


1,230 


39.3% 


285 


9.1% 


535 


17.1% 


40 


20-24 


9,014 


76.7% 


4,208 


35.8% 


4,806 


40.9% 


1,138 


9.7% 


1,601 


13.6% 


141 


25-29 


15,348 


84.0% 


7,192 


39.4% 


8,156 


44.6% 


1,496 


8.2% 


1,427 


7.8% 


165 


30-34 


23,332 


87.5% 


10,845 


40.7% 


12,487 


46.8% 


1,949 


7.3% 


1,375 


5.2% 


173 


35-39 


13,153 


88.9% 


6,378 


43.1% 


6,775 


45.8% 


897 


6.1% 


739 


5.0% 


100 


40+ 


2,988 


88.2% 


1,590 


46.9% 


1,398 


41.3% 


203 


6.0% 


198 


5.8% 


30 


Educational Attainment 




< than High School 


5,517 


70.7% 


2,775 


35.5% 


2,742 


35.1% 


810 10.4% 


1,479 


18.9% 


109 


High School 


15,824 


80.9% 


7,682 


39.3% 


8,142 


41.6% 


1,718 


8.8% 


2,017 


10.3% 


203 


Some college 


15.155 


85.1% 


7,471 


41.9% 


7,684 


43.1% 


1,300 


7.3% 


1,358 


7.6% 


131 


College 


18,990 


88.8% 


8,604 


40.2% 


10,386 


48.6% 


1,483 


6.9% 


904 


4.2% 


107 


More than college 


11,591 


90.4% 


5,205 


40.6% 


6,386 


49.8% 


796 


6.2% 


434 


3.4% 


. 61 


Race/Hispanic Ethnicity 




Hispanic 


7,581 


78.5% 


3,680 


38.1% 


3,901 


40.4% 


883 


9.1% 


1,197 


12.4% 


103 


White non-Hispanic 


49,704 


86.8% 


23,470 


41.0% 


26,234 


45.8% 


4,286 


7.5% 


3,263 


5.7% 


351 


Black non-Hispanic 


4,405 


76.1% 


2,165 


37.4% 


2,240 


38.7% 


421 


7.3% 


964 


16.6% 


112 


Asian 


4,253 


81.9% 


1,932 


37.2% 


2,321 


44.7% 


385 


7.4% 


552 


10.6% 


34 


Other 


1,178 


76.7% 


515 


33.6% 


663 


43.2% 


136 


8.9% 


221 


14.4% 


13 


D If II I [Jldtc 






50,058 


85.9% 


23.807 


40.8% 


26,251 


45.0% 


4,501 


7.7% 


3,734 


6.4% 


451 


Puerto Rico/U.S. Terr. 


1,546 


79.0% 


749 


38.3% 


797 


40.7% 


193 


9.9% 


218 


11.1% 


26 


Non-U. S.-Born 


15,516 


80.9% 


7.211 


37.6% 


8,305 


43.3% 


1,420 


7.4% 


2,241 


11.7% 


180 


Parity 3 


Preqnancy-Related Factors 


1 


29,580 


84.3% 


13,834 


39.4% 


15,746 


44 9% 


2,707 


7.7% 


2,785 


7.9% 


214 


2-3 


33,354 


85.6% 


15,832 


40.6% 


17,522 


45.0% 


2,947 


7.6% 


2,670 


6.9% 


277 


4+ 


4,170 


77.6% 


2,103 


39.1% 


2,067 


38.5% 


461 


8.6% 


742 


13.8% 


52 


Smoking 4 




Yes 


4,482 


74.1% 


2,317 


38.3% 


2,165 


35.8% 


613 10.1% 


954 


15.8% 


74 


No 


62,608 


85.4% 


29,431 


40.1% 


33.177 


45.2% 


5,490 


7.5% 


5,236 


7.1% 


532 


Plurality 


Birth Outcomes 


Singleton 


63,633 


84.0% 


28,701 


37.9% 


34,932 


46.1% 


6,052 


8.0% 


6,054 


8.0% 


628 


Multiple birth 


3,540 


94.2% 


3,086 


82.2% 


454 


12.1% 


67 


1.8% 


149 


4.0% 


44 


Birthweight 




<500 g 


110 


88.0% 


102 


81.6% 


8 


6.4% 


2 


_5 


13 


10.4% 


5 


500-1,499 g 


874 


91.4% 


782 


81.8% 


92 


9.6% 


15 


1 .6% 


67 


7.0% 


29 


1,499-2,499 g 


4,366 


88.5% 


3,526 


71.5% 


840 


17.0% 


169 


3.4% 


397 


8.0% 


68 


2,500-3,999 g 


54,443 


84.0% 


24,559 


37.9% 


29,884 


46.1% 


5,143 


7.9% 


5,195 


8.0% 


381 


4,000+ g 


7,368 


84.8% 


2,812 


32.4% 


4,556 


52.4% 


789 


9.1% 


530 


6.1% 


51 


Gestational Age 




<28 weeks 


446 


90.5% 


396 


80.3% 


50 


10.1% 


4 


_5 


43 


8.7% 


21 


<37 weeks 


6,180 


90.1% 


5,381 


78.4% 


799 


11.6% 


166 


2.4% 


516 


7.5% 


101 


37-42 weeks 


60,677 


84.0% 


26,286 


36.4% 


34,391 


47.6% 


5,922 


8.2% 


5,628 


7.8% 


366 


NOTE: All percentages are calculated based on only those births with known values for the characteristics) of interest, unless otherwise stated. 
1 . Based on the Adequacy of Prenatal Care Utilization (APNCU) Index. See Section Definitions for an explanation of Index and its categories. 2. Adequate 
Total is the sum of Adequate Intensive and Adequate Basic 3. Parity is the number of live births including this birth. 4. Smoking dunng pregnancy is self- 
reported by the mother and should be interpreted with caution 5. Calculations based on fewer than five events are excluded. 



62 



Table B-11 (continued). > 
State Total 


Adequacy of Pi 

Adequate Total 2 

n % 
73,809 92.8% 


enatal Care In 
20 

Adequate 
Intensive 

n % 
33,748 42.5% 


itiation 1 by Sel 
33 

Adequate Basic 

n % 
40,061 50.4% 


ected Charac 
Intermediate 

n % 
3 611 4 5% 


teristics, Mass 
Inadequate 

n % 
2 075 2 6% 


achusetts 

Unknown 
n 

67? 


Age 


Maternal Demoqraphics 


<18 

18-19 

20-24 

25-29 

30-34 

35-39 

40+ 


1,197 79.4% 
2.630 84.1% 
10.272 87.4% 
16.979 92.9% 
25.412 95.3% 
14,112 95.4% 
3.203 94.5% 


422 28.0% 
992 31.7% 
4,368 37.2% 
7,860 43.0% 
12,017 45.1% 
6,630 44.8% 
1,456 43.0% 


775 51.4% 
1.638 52.4% 
5,904 50.2% 
9,119 49.9% 
13,395 50.3% 
7,482 50.6% 
1,747 51.5% 


192 12.7% 
343 11.0% 
952 8.1% 
805 4.4% 
781 2.9% 
428 2.9% 
110 3.2% 


118 7.8% 
153 4.9% 
529 4.5% 
487 2.7% 
463 1.7% 
249 1.7% 
76 2.2% 


22 
40 
141 
165 
173 
100 
30 


Educational Attainment 




< than High School 
High School 
Some college 
College 

More than college 


6,431 82.4% 
17,697 90.5% 
16,564 93.0% 
20,575 96.2% 
12,433 97.0% 


2,342 30.0% 
7,513 38.4% 
7,555 42.4% 
9,693 45.3% 
6,598 51.5% 


4,089 52.4% 
10,184 52.1% 

9,009 50.6% 
10,882 50.9% 

5,835 45.5% 


889 11.4% 
1.190 6.1% 
805 4.5% 
480 2.2% 
240 1.9% 


486 6.2% 
672 3.4% 
444 2.5% 
322 1.5% 
148 1.2% 


109 
203 
131 
107 
61 


Race/Hispanic Ethnicity 




Hispanic 

White non-Hispanic 
Black non-Hispanic 
Asian 
Other 


8,548 88.5% 
54,311 94.9% 
4,892 84.5% 
4,676 90.1% 
1.322 86.1% 


3,860 40.0% 
25.118 43.9% 
2,282 39.4% 
1,874 36.1% 
593 38.6% 


4,688 48.5% 
29,193 51.0% 
2,610 45.1% 
2,802 54.0% 
729 47.5% 


762 7.9% 
1,901 3.3% 
477 8.2% 
346 6.7% 
120 7.8% 


351 3.6% 
1,041 1.8% 
421 7.3% 
168 3.2% 
93 6.1% 


103 
351 
112 
34 
13 


Birthplace 




U.S. States/D.C. 
Puerto Rico/U.S. Terr. 
Non-U.S.-Born 


54,907 94.2% 
1,763 90.1% 
17,080 89.1% 


25,308 43.4% 
781 39.9% 
7,620 39.7% 


29,599 50.8% 
982 50.2% 
9,460 49.3% 


2.233 3.8% 
133 6.8% 
1,237 6.5% 


1.153 2.0% 
61 3.1% 
860 4.5% 


451 
26 
180 


Parity 3 


Preqnancy-Related Factors 


1 

2-3 
4+ 


32,513 92.7% 
36,542 93.8% 
4,681 87.1% 


15,034 42.9% 
16,682 42.8% 
1,979 36.8% 


17,479 49.8% 
19,860 51.0% 
2,702 50.3% 


1,614 4.6% 
1,547 4.0% 
448 8.3% 


945 2.7% 
882 2.3% 
244 4.5% 


214 

277 
52 


Smoking 4 




Yes 
No 


5,174 85.5% 
68.535 93.5% 


1,996 33.0% 
31,710 43.2% 


3,178 52.5% 
36,825 50.2% 


519 8.6% 
3.084 4.2% 


356 5.9% 
1,715 2.3% 


74 
532 


Plurality 


Birth Outcomes 


Singleton 
Multiple Dircn 


70,189 92.7% 
3,620 96.4% 


31,905 42.1% 
1,843 49.1% 


38,284 50.5% 
1,777 47.3% 


3,506 4.6% 
105 2.8% 


2,044 2.7% 
31 0.8% 


628 
44 


Birthweight 




<500 g 
500-1,499 g 

1.499- 2,499 g 

2.500- 3,999 g 
4,000+ g 


112 89.6% 
901 94.2% 
4,572 92.7% 
59,998 92.6% 
8,213 94.5% 


49 39.2% 
483 50.5% 
2,145 43.5% 
27,312 42.2% 
3,753 43.2% 


63 50 4% 
418 43.7% 
2,427 49.2% 
32,686 50.5% 
4,460 51.3% 


7 5.6% 
35 3.7% 
232 4.7% 
3.027 4.7% 
309 3.6% 


6 4.8% 
20 2.1% 
128 2.6% 
1,756 2.7% 
165 1.9% 


5 
29 
68 
381 
51 


Gestational Age 




<28 weeks 
<37 weeks 
37-42 weeks 

NOTE: All percentages are calculated ba; 

1. Based on the Adequacy of Initiation InC 

2. Adequate Total is the sum of Adequate 
pregnancy is self-reported by the mother 


454 92.1% 
6,394 93.2% 
67,065 92.9% 
>ed on only those birth 
ex. a component inde 
Intensive and Adequ; 
and should be interpre 


227 46.0% 

3,183 46.4% 

30,430 42.1% 
s with known values f 
x of the APNCU Index 
ite Basic. 3. Parity is 
ted with caution. 


227 46.0% 
3,211 46.8% 
36.635 50.7% 
3r the characteristics 
. See Section Definiti 
the number of live birt 


21 4.3% 

323 4.7% 

3,256 4.5% 
of interest, unless o 
ons for an explanatic 
ns including this birtr 


18 3.7% 
145 2.1% 
1,906 2.6% 
therwise stated. 
>n of Index and its cati 
. 4. Smoking during 


21 
101 

366 

jgories. 



Table B-1 2. Birth Characteristics by Race/Hispanic Ethnicity and Source of Prenatal Care Payment 

(Public/Private), Massachusetts: 2003 



Race/Ethnicity and 
Payment Source 



Births 


i 




Teen Births 






Birthweight 








<18 Years 


<20 Years 


Very Low 2 


Low 3 




n 


% 


n 


ft/ 

% 


n 


% 


n 


% 


N 


% 


80,167 


100.0 


1,529 


1.9 


4,695 


5.9 


1,115 


1.4 


6,115 


7.6 


22,685 


28.9 


1,098 


4.8 


3,472 


15.3 


327 


1.4 


1,925 


8.5 


17,948 


22.9 


889 


5.0 


2,783 


15.5 


265 


1.5 


1.532 


8.5 


A 7*57 


ft n 

D.U 


209 


4.4 


689 


14.5 


62 


1.3 


393 


o.o 


54,913 


70.0 


380 


0.7 


1,073 


2.0 


697 


1.3 


3,889 


7.1 


57,604 


100.0 


593 


1.0 


2,223 


3.9 


714 


1.2 


4,038 


7.0 


10,398 


18.5 


345 


3.3 


1,454 


14.0 


107 


1 


793 


7.6 


8,590 


15.3 


309 


3.6 


1,249 


14.5 


95 


1.1 


67? 


7.8 


1,808 


3.2 


36 


2.0 


205 


11.3 


12 


0.7 


121 


6.7 


45,237 


80.5 


223 


0.5 


687 


1.5 


542 


1.2 


3.028 


6.7 


5 902 


100 


201 


3.4 


557 


9.4 


185 


3.1 


715 


12 1 


1 417 


Sft 9 


167 


4.9 


446 


13.1 


97 


2.8 


387 


1 1 .o 




4^ Q 

H J. £7 


129 


4.8 


345 


13.0 . 


75 


2.8 


307 


11 K 






38 


5.0 


101 


13.4 


22 


2.9 


80 




2,312 


39.9 


27 


1.2 


93 


4.0 


76 


3.3 


288 


12.5 


9,764 


100 


619 


6.3 


1,581 


16.2 


128 


1.3 


805 


8.2 


6,614 


68.2 


498 


7.5 


1,312 


19.8 


87 


1.3 


565 


8.5 


4,788 


49 4 

*T3 .*t 


369 


7.7 


957 


20.0 


64 


1.3 


396 


8.3 


1,826 


18.8 


129 


7.1 


355 


19.4 


23 


1J3 


169 


9.3 


2,943 


30.3 


107 


3.6 


235 


8.0 


38 


1.3 


224 


7.6 


5,224 


100.0 


69 


A O 

1.3 


A O O 

182 


3.5 


60 


A A 
1.1 




8.1 


1,392 


26.9 


52 


3.7 


140 


10.1 


23 


1.7 


111 


8.0 


1,190 


23.0 


49 


4.1 


129 


10.8 


21 


1.8 


95 


8.0 


202 


3.9 


3 


_8 


11 


5.4 


2 


8 


16 


7.9 


3 74fi 


72 3 


13 


0.3 


36 


1.0 


32 


0.9 


301 


8.0 


1,548 


100.0 


45 


2.9 


146 


9.4 


24 


1.6 


126 


8.1 


851 


56.2 


35 


4.1 


117 


13.7 


13 


1.5 


68 


8.0 


711 


47.0 


32 


4.5 


101 


14.2 


10 


1.4 


61 


8.6 


140 


9.3 


3 


8 


16 


11.4 


3 


_8 


7 . 


5.0 


630 


41.6 


10 


1.6 


22 


3.5 


8 


1.3 


44 


7.0 



STATE TOTAL 



Public 

Medicaid 5 
Other Public* 

Private 7 



White non-Hispanic 



Public 

Medicaid 5 
Other Public 6 

Private 7 



Black non-Hispanic 

Public 

Medicaid 5 
Other Public 6 

Private 7 

Hispanic 

Public 

Medicaid 5 
Other Public 6 

Private 7 

Asian 

Public 

Medicaid 5 
Other Public 6 

Private 7 



| Other a 
Public 

Medicaid 5 
Other Public 6 
Private 7 



64 



Table B-12 (continued). Birth Characteristics by Race/Hispanic Ethnicity and Source of 
Prenatal Care Payment (Public/Private), Massachusetts: 2003 



Prenatal Care 



Race/Ethnicity and 
Payment Source 



Adequate 



Began 1st Trimester Cesarean Section 



% 



% 



Breastfeeding 
n 



11 



STATE TOTAL 4 



Public 

Medicaid 5 
Other Public* 
Private 7 



White non-Hispanic 

Public 

Medicaid 5 
Other Public 6 

Private 7 



Black non-Hispanic 



Public 

Medicaid 5 
Other Public 6 

Private 7 



Hispanic 

Public 

Medicaid 5 
Other Public 6 

Private 7 



Asian 



Public 

Medicaid 5 
Other Public 6 

Private 7 



Other 



Public 

Medicaid 5 
Other Public 6 

Private 7 



67,173 


84.5 


66,789 


83.9 


23,392 


29.3 


61,388 


78.1 


16,801 


74.8 


16,125 


71.6 


5,773 


25.5 


15,656 


69.2 


13,484 


75.7 


12,946 


72.5 


4,567 


25.5 


12,150 


67.8 


3,317 


71.4 


3,179 


68.0 


1,206 


25.7 


3,506 


74.7 


4ft 7D9 


ftQ n 


AO Q71 


QQ A 


1 C QQ7 


o\ .1) 


A A oce 


O 4 Q 


49,704 


86.8 


49,980 


87.2 


17,235 


30.1 


43,338 


77.0 


7,972 


77.1 


7,659 


74.0 


2,676 


25.8 


6,411 


61.8 


6,604 


77.2 


6,352 


74.2 


2,195 


25.6 


5,111 


59.6 


1,368 


76.6 


1,307 


73.0 


481 


26.8 


1,300 


72.5 


40,307 


89.4 


40,872 


90.5 


14,064 


31.2 


36,369 


80.6 


4,405 


76.1 


4,195 


71.9 


1,808 


30.8 


4,644 


79.5 


2,302 


69.0 


2,194 


65.1 


972 


28.5 


2,551 


74.8 


1,857 


71.2 


1,766 


67.0 


756 


28.5 


2,005 


75.4 


445 


61.3 


428 


58.2 


216 


28.7 


546 


72.6 


2,037 


88.6 


1,932 


83.9 


787 


34.3 


2,007 


87.1 


7,581 


78.5 


7,358 


76.0 


2,507 


25.8 


7,840 


80.8 


4,939 


75.4 


4,814 


73.3 


1,635 


24.8 


5,118 


77.8 


3,658 


77.0 


3,576 


75.1 


1,202 


25.2 


3,733 


78.1 


1,281 


71.4 


1,238 


68.6 


433 


24.0 


1,385 


76.8 


2,544 


86.7 


2,447 


83.3 


830 


28.3 


2,574 


87.6 


4,253 


81.9 


4,044 


77.9 


1,386 


26.6 


4,266 


82.1 


984 


71.3 


873 


63.1 


272 


19.6 


893 


64.2 


04b 


t\.o 


/ 4b 


DO.U 


2.2.6 


«l O *7 


T3 Q 


K)2.U 


138 


69.0 


127 


63.5 


49 


24.4 


155 


77.1 


3,228 


86.4 


3,130 


83.7 


1,096 


29.3 


3,322 


88.7 


1,178 


76.7 


1,158 


75.2 


432 


28.1 


1,259 


82.8 


595 


70.3 


578 


68.2 


214 


25.2 


677 


79.6 


512 


72.3 


502 


70.8 


187 


26.4 


559 


78.7 


83 


60.1 


76 


55.1 


27 


19.3 


118 


84.3 


549 


87.8 


549 


87.6 


198 


31.6 


552 


87.6 



NOTE: All percentages are calculated based on only those births with known values for the characteristic(s) of interest, unless otherwise stated. 
1 . In the "Births" column, percentages are based on race/ethnicity category totals (in column). For all other characteristics, percentages are based on the total 
number of births for the race/ethnicity by payment source for the row. 2. Very low birthweight: less than 1 .500 grams or 3.3 pounds. 3. Low Birthweight: less 
than 2,500 grams or 5.5 pounds. 4. Total births do not equal Public + Private because Workers' Compensation, self-paid, and other are in the state total but 
not shown in the table. 5. Medicaid/MassHealth. 6. Other Public: Commonhealth, Healthy Start, Medicare, other government programs, and free care. 
7. Private: commercial indemnity plans or commercial managed care orgs. (HMO, PPO, IPP, or IPA). 8. Calculations based on fewer than five events are 
excluded. 9. Other. Mothers who designated their race as American Indian or "Other." 10. Based on the Adequacy of Prenatal Care Utilization (APNCU) 
Index. 1 1 . Mother was breastfeeding or intending to breastfeed at the time the birth certificate was completed. 



65 



Table B-13. Cesarean Section Deliveries and Vaginal Births after Cesarean Section (VBACs) by 
Hospital or Medical Center, All Births, Massachusetts: 2003 



Occurrence Total C- Primary C- Repeat C- 

Facility Births 1 Sections Section 1 Section 1 VBACs 1 







n 


«/ 2.3 

°/o 


n 


„ , 5.4 
°/o 


n 


°/0 


n 


■ , £ 

% 6 


State Total 


81,309 


23,860 


29.5 


15,150 


21.4 


8,710 


87.5 


1,240 


12.5 


Anna Jaques Hosp. 


792 


206 


26.0 


119 


17.3 


87 


82.1 


19 


17.9 


Baystate Med. Ctr. 


4,283 


1,145 


27.7 


741 


20.3 


404 


84.0 


77 


16.0 


Berkshire Med. Ctr. 


788 


170 


21.6 


108 


15.3 


62 


74.7 


21 


25.3 


Beth Israel Deaconess 
Mfid Ctr 


5,035 


1,819 


36.1 


1,191 


27.7 


628 


85.7 


105 


14.3 


Beverly Hosp. 


2,312 


647 


28.0 


396 


19.6 


251 


86.0 


41 


14.0 


Boston Med. Ctr. 


2,087 


555 


26.6 


361 


19.4 


194 


86.2 


31 


13.8 


Brigham And Women's 


9,402 


2,925 


31.2 


2,014 


24.5 


911 


80.5 


220 


19.5 


Brockton Hosp. 


1,219 


364 


29.9 


254 


23.5 


110 


79.1 


29 


20.9 


Cambridge Hosp. 


1,066 


274 


26.7 


179 


19.6 


95 


81.9 


21 


18.1 


Cape Cod Hosp. 


1,001 


271 


27.1 


149 


17.3 


122 


85.9 


20 


14.1 


Caritas Good Samaritan 
Mfid Ctr 


1,021 


341 


33.4 


203 


23.1 


138 


97.9 


3 


7 


Caritas Norwood Hosp. 


644 


210 


32.7 


138 


24.6 


72 


87.8 


10 


12.2 


Caritas St. Elizabeth's 


1,464 


520 


35.6 


341 


27.0 


179 


91.3 


17 


8.7 


Charlton Memorial Hosp. 


1,729 


504 


29.1 


329 


21.4 


175 


90.2 


19 


9.8 


Cooley Dickinson Hosp. 


911 


243 


26.7 


148 


18.6 


95 


81.9 


21 


18.1 


Emerson Hosp. 


1,319 


428 


32.4 


273 


23.8 


155 


90.6 


16 


9.4 


Fairview Hosp. 


174 


47 


27.0 


23 


15.4 


24 


96.0 


1 


7 


Falmouth Hosp. 


641 


173 


27.0 


106 


18.5 


67 


100.0 





0.0 


Franklin Med. Ctr. 


464 


116 


25.0 


71 


17.5 


45 


77.6 


13 


22.4 


Harrington Memorial Hosp. 


462 


117 


25.9 


68 


17.3 


49 


84.5 


9 


15.5 


Heywood Memorial Hosp. 


597 


117 


19.6 


66 


12.5 


51 


73.9 


18 


26.1 


Holy Family Hosp. And 
Med Ctr. 


1,386 


502 


36.2 


317 


26.6 


185 


95.4 


9 


4.6 


Holyoke Hosp. 


563 


129 


22.9 


82 


16.3 


47 


79.7 


12 


20.3 


Jordan Hosp. 


738 


184 


24.9 


117 


17.5 


67 


95.7 


3 


7 


Lawrence General Hosp. 


1,742 


498 


28.6 


244 


16.6 


254 


94.4 


15 


5.6 


Leominster Hosp. 


1,215 


291 


24.1 


158 


14.8 


133 


91.7 


12 


8.3 


Lowell General Hosp. 


1,951 


563 


28.9 


324 


19.3 


239 


88.2 


32 


11.8 


Martha's Vineyard Hosp. 


137 


41 


29.9 


21 


18.1 


20 


95.2 


1 


7 


Mary Lane Hosp. 


148 


48 


32.4 


28 


21.9 


20 


100.0 





0.0 



66 



Table B-13. (continued). Cesarean Section Deliveries and Vaginal Births After Cesarean Section 
(VBACs) by Hospital or Medical Center, All Births, Massachusetts: 2003 



Occurrence Total C- Primary C- Repeat C- VBACs 1 

Facility Births 1 Sections Section 1 Section 1 

n % 2 ' 3 n Vo 2,4 n % 25 n % 6 



Maccarhi i c otic ^onoro I U ncn 
McloOaU HJRkTUo Ocllclal nUofJ. 


3.587 


1,056 


29.4 


760 


23.4 


296 


87.1 


44 


12.9 




1,721 


585 


34.0 


321 


22.3 


264 


94.0 


17 


6.0 




1,406 


306 


21.8 


193 


15.2 


113 


83.7 


22 


16.3 


Metrowest Med. Ctr.-Framingham 




















Union Campus 


2,211 


751 


34.0 


466 


24.2 


285 


100.0 





0.0 


Milford-Whitinsville Regional Hosp. 


904 


278 


30.8 


180 


22.7 


98 


89.1 


12 


10.9 


Morton Hosp. 


523 


151 


29.4 


70 


16.5 


81 


92.0 


7 


8.0 


Mount Auburn Hosp. 


1,730 


425 


24.6 


276 


17.9 


149 


80.5 


36 


19.5 


Nantucket Cottage Hosp. 


96 


25 


CXJm \J 


1^ 

1 o 


15 5 


19 


mn n 




n n 




3,072 


1,025 


33.4 


641 


24.2 


384 


91.4 


36 


8.6 


iNonn Adams r\egionai nosp. 


303 


106 


35.0 


70 


26.7 


36 


87.8 


5 


12.2 


North Shore Med. Ctr.. - Salem Hosp. 


1,849 


555 


30.0 


368 


22.4 


187 


90.3 


20 


9.7 


Saint Vincent Hosp. 


1,842 


443 


24.4 


287 


17.8 


156 


78.8 


42 


21.2 


Saints Memorial Medical Ctr. 


724 


246 


34.0 


161 


25.3 


85 


96.6 


3 


3.4 


South Shore Hosp. 


4,162 


1,218 


29.3 


724 


20.0 


494 


90.6 


51 


9.4 


St. Luke's Hosp. 


1,527 


371 


24.5 


206 


15.5 


165 


88.2 


22 


11.8 


Sturdy Memorial Hosp. 


1,056 


337 


31.9 


197 


21.7 


140 


94.6 


8 


5.4 


Tobey Hosp. 


525 


73 


16.2 


45 


10.8 


28 


80.0 


7 


20.0 


Tufts-New England Med. Ctr. Hosp. 


1,419 


521 


36.7 


342 


28.1 


179 


89.1 


22 


10.9 


UMass Memorial Med. Ctr. - West 




















Campus 


4,473 


1,226 


27.4 


813 


20.4 


413 


86.2 


66 


13.8 


Winchester Hosp. 


2,261 


713 


31.5 


447 


22.6 


266 


94.7 


15 


5.3 



NOTES: All percentages are calculated based on only those births with known values for the characteristic(s) of interest, 
unless otherwise stated. 

1. See Section Definitions for definitions of occurrence births, primary and repeat Cesarean sections, and VBACs. The 
percentages provided in this table are based on occurrence births, and may differ from data, which are based on resident 
births, presented elsewhere in this book. 2. The percentage of Cesarean births reported is not adjusted for risk factors such 
as mother's age, birthweight, or complications of labor and delivery, which would influence the number of procedures in a 
particular facility. Caution should be used when comparing unadjusted percentages. 3. Percentage of total Cesarean 
sections= (total Cesarean births/all births) x 100. 4. Percentage primary Cesarean sections= (primary Cesarean sections/all 
births-repeat Cesarean sections-VBACs) x 100. 5. Percentage repeat Cesarean sections= (repeat Cesarean sections/ 
(repeat Cesarean sections + VBACs)) x100. 6. Percentage VBACs= (VBAC deliveries/ (repeat Cesarean sections + VBAC)) 
x 100. 7. Calculations based on fewer than five events are excluded. 



67 



Table B-14. Cesarean Section Deliveries for Singleton Births by Hospital or Medical Center and 

Number of Previous Births, Massachusetts: 2003 



Facility 



First Birth 



Second or Later Birth 
without prior C-section 



Second or Later Birth 
with prior C-section 





RirthQ 1 

Dll If lo 


C-section 
n % 2 


Rirth« 1 

Dll 11 lo 


C-section 
n % 2 


Rirthc 1 

Dll 11 lo 


C-section 
n % 2 


State Total 


34,505 


10,050 


29.1 


32,978 


2,900 


8.8 


9,378 


8,184 


87.3 


Anna Jaques Hosp. 


297 


90 


30.3 


375 


27 


7.2 


104 


85 


81.7 


Baystate Med. Ctr. 


1,618 


450 


27.8 


1,785 


145 


8.1 


454 


380 


83.7 


Berkshire Med. Ctr. 


351 


75 


21.4 


334 


23 


6.9 


79 


58 


73.4 


Beth Israel Deaconess Med. Ctr. 


2.198 


765 


34.8 


1,799 


199 


11.1 


689 


589 


85.5 


Beverly Hosp. 


949 


268 


28.2 


988 


77 


7.8 


284 


243 


85.6 


Boston Med. Ctr. 


900 


226 


25.1 


919 


112 


12.2 


218 


190 


87.2 


Brigham And Women's Hosp. 


4,227 


1,229 


29.1 


3,313 


301 


9.1 


968 


774 


80.0 


Brockton Hosp. 


531 


165 


31.1 


511 


66 


12.9 


137 


108 


78.8 


Cambridge Hosp. 


578 


145 


25.1 


319 


28 


8.8 


114 


93 


81.6 


Cape Cod Hosp. 


427 


108 


25.3 


404 


22 


5.4 


140 


120 


85.7 


Caritas Good Samaritan Med. Ctr. 


381 


144 


37.8 


471 


49 


10.4 


133 


130 


97.7 


Caritas Norwood Hosp. 


284 


110 


38.7 


263 


19 


7.2 


80 


70 


87.5 


Caritas St. Elizabeth's 


624 


214 


34.3 


530 


51 


9.6 


185 


168 


90.8 


Charlton Memorial Hosp. 


752 


216 


28.7 


734 


83 


11.3 


184 


165 


89.7 


Cooley Dickinson Hosp. 


383 


108 


28.2 


380 


24 


6.3 


114 


93 


81.6 


Emerson Hosp. 


524 


187 


35.7 


572 


44 


7.7 


167 


151 


90.4 


Fairview Hosp. 


78 


20 


25.6 


69 


3 


3 


25 


24 


96.0 


Falmouth Hosp. 


289 


82 


28.4 


280 


24 


8.6 


65 


65 


100.0 


Franklin Med. Ctr. 


195 


55 


28.2 


201 


9 


4.5 


54 


41 


75.9 


Harrington Memorial Hosp. 


188 


50 


26.6 


201 


16 


8.0 


58 


49 


84.5 


Heywood Memorial Hosp. 


240 


51 


21.3 


276 


11 


4.0 


62 


44 


71.0 


Holy Family Hosp. And Med. Ctr. 


596 


239 


40.1 


568 


58 


10.2 


188 


179 


95.2 


Holyoke Hosp. . 


242 


47 


19.4 


254 


28 


11.0 


55 


45 


81.8 


Jordan Hosp. 


362 


89 


24.6 


282 


15 


5.3 


68 


65 


95.6 


Lawrence General Hosp. 


663 


157 


23.7 


768 


56 


7.3 


262 


247 


94.3 


Leominster Hosp. 


516 


115 


22.3 


537 


36 


6.7 


138 


126 


91.3 


Lowell General Hosp. 


782 


209 


26.7 


842 


82 


9.7 


250 


218 


87.2 


Martha's Vineyard Hosp. 


63 


14 


22.2 


51 


5 


9.8 


21 


20 


95.2 


Mary Lane Hosp. 


53 


17 


32.1 


75 


11 


14.7 


18 


18 


100.0 



68 



Table B-14 (continued). Cesarean Section Deliveries for Singleton Births by Hospital or Medical 
Center and Number of Previous Births, Massachusetts: 2003 



Second or Later Birth Second or Later Birth 
without prior C-section with prior C-section 



Facility 


Births 


C-section 
n % 2 


Births 


C-section 
n % 2 


Births 


C-section 
n % 2 


Massachusetts General Hosp. 


1,696 


OU / 


9Q Q 

zy .y 


1,378 


|4 I 


I u.z 


300 


9^7 
ZD / 


OO. / 


Melrose-Wakefield Hosp. 


708 


ZUO 


OQ A 


682 


7Q 

/y 


1 1 
I I .D 


273 


OKQ 
ZOO 


QA C\ 


Mercy Med. Ctr. 


545 




OR 7 


710 


A7 


fi fi 
O.D 


135 


1 1 o 


ft^ 7 
OO. / 


Metrowest Med. Cntr.-Framingham 




















Union Campus 


1 ,U4o 


361 


34.5 


QOO 


74 


9.0 


077 


277 


100.0 


Milford-Whitinsville Reaional Hosd 

1 VI II 1 \J 1 VJ t V 1 Mill 1 w VII Iv I \\/M Ivl I \Jt 1 1 1 V/ VW • 


•30*5 


135 


34.4 


ooo 


37 


9.6 


1 07 
1U/ 


95 


88.8 


Morton Hosd 


1 QA 


44 


22.7 




19 


8.5 


07 
Of 


80 


92.0 


Mnunt Auburn Ho^n 


oiy 


218 


26.6 


o/U 


34 


5.1 


1 QO 

loo 


147 


80.3 


Nantucket Cottaap Hosn 


A Q 

40 


13 


27.1 


oo 





0.0 


1 o 


12 


100.0 


N*a\A/tnn-\A/pllpc;|p\/ Hn^n 


A 07 A 
1,2/1 


44.fi 

H*tO 


1 

OO. I 


A OOO 

i, Zoo 


m° 

1 


ft "\ 

o.o 


40/ 


^71 


Q1 9 


iNonn Aoams Kegionai nosp. 


124 


54 


43.5 


129 


12 


9.3 


41 


0£> 

36 


OT O 

87.8 


North Shore Med. Cntr. - Salem Hosp. 


777 


233 


30.0 


784 


87 


11.1 


197 


177 


89.8 


Saint Vincent Hosp. 


786 


205 


26.1 


781 


50 


6.4 


190 


148 


77.9 


Saints Memorial Medical Ctr. 


337 


115 


34.1 


281 


29 


10.3 


86 


83 


96.5 


South Shore Hosp. 


1,613 


455 


28.2 


1,814 


144 


7.9 


519 


470 


90.6 


St. Luke's Hosp. 


615 


146 


23.7 


685 


47 


6.9 


181 


159 


87.8 


Sturdy Memorial Hosp. 


429 


146 


34.0 


458 


40 


8.7 


144 


136 


94.4 


Tobey Hosp. 


186 


26 


14.0 


219 


13 


5.9 


35 


28 


80.0 


Tufts-New England Med. Ctr. Hosp. 


549 


174 


31.7 


495 


60 


12.1 


175 


155 


88.6 


UMass Memorial Med. Ctr. - West 




















Campus 


2,002 


479 


23.9 


1,731 


175 


10.1 


441 


375 


85.0 


Winchester Hosp. 


882 


299 


33.9 


992 


86 


8.7 


264 


249 


94.3 



NOTES: All percentages are calculated based on only those births with known values for the characteristic(s) of interest, unless 
otherwise stated. 

1 . Occurrence births, see Section Definitions. 2. The percentage of Cesarean births reported is not adjusted for risk factors such 
as mother's age, birthweight, or complications of labor and delivery, which would influence the number of procedures in a 
particular facility. Caution should be used when comparing unadjusted percentages. 3. Calculations based on fewer than five 
events are excluded. 



69 



Table B-15. Birth Characteristics by Hospital or Medical Center, Massachusetts: 2003 



Facility 


Location 


Occurrence 
Births 2 
(n) 


Low 
Birthweight 3 
(%) 


Public 
Payment 

for 
Delivery 

/•>/ \ 


Adequate 
Prenatal 
Care 5 (%) 


STATE TOTAL 6 




81,309 


7.6 


28.2 




84.5 


Anna Jaques Hosp. 


Newburyport 


792 


3.4 


19.5 


90.3 


Baystate Medical Ctr. 


Springfield 


4,283 


12.5 


42.7 


81.7 


Berkshire Medical Ctr. 


Pittsfield 


788 


5.3 


38.4 


56.1 


Beth Israel Deaconess Medical Ctr. 


Boston 


5,035 


1 1 .4 


17.7 


93.4 


Beverly Hosp. 


Beverly 


2,312 


5.1 


25.7 


95.1 


Birthplace At Wellesley 


Wellesley 


120 


0.0 


0.0 


88.3 


Boston Medical Ctr. 


Boston 


2,087 


9.5 


85.3 


52.3 


Brigham And Women's Hosp. 


Boston 


9,402 


10.3 


17.2 


98.3 


Brockton Hosp. 


Brockton 


1,219 


8.2 


57.1 


79.0 


Cambridge Birth Ctr. 


Cambridge 


92 


7 


31 .5 


70.7 


Cambridge Hosp. 


Cambridge 


1,066 


2.7 


56.7 


76.4 


Cape Cod Hosp. 


Barnstable 


1,001 


2.9 


38.1 


88.3 


Caritas Good Samaritan Medical Ctr. 


Brockton 


1,021 


6.2 


45.7 


68.9 


Caritas St. Elizabeth's Medical Ctr. 


Boston 


1,464 


13.9 


16.8 


86.9 


Caritas Norwood Hosp. 


Norwood 


644 


3.7 


A C A 

15.4 


QO 7 

o2.7 


Chariton Memorial Hosp. 


Fall River 


1,729 


7.3 


A A O 
44.8 


o9.o 


Cooley Dickinson Hosp. 


Northampton 


911 


2.3 


r\ A A 

24.4 


92.4 


Emerson Hosp. 


Concord 


1,319 


A A 

4.4 


o 7 
0. 7 


00 7 


Fairview Hosp. 


Great Barrington 


174 


o n 

2.9 


47./ 


7Q 7 


Falmouth Hosp. 


Falmouth 


641 


3.9 


30.1 


7n n 
79.9 


Franklin Medical Ctr. 


Greenfield 


464 


O A 

3.4 


07 7 

37.7 


ob.4 


■ I • A k A * 1 II _ 

Harrington Memorial Hosp. 


Southbndge 


462 


1 .8 


>• 7 7 
47.7 


00. y 


Heywood Memorial Hosp. 


Gardner 


by/ 


o o 
o.2 


0.0 c 


OU.D 


Holy Family Hospital And Medical Ctr. 


Methuen 


1 ,JOD 


4.0 


1/1 Q 

14. y 




Holyoke Hosp. 


Holyoke 


ODO 


o c 
6.0 


DD.O 


7Q A 


Jordan nosp. 


r lyillUUlfl 




4 7 
*+. / 


25 5 


71.0 


Lawrence General Hosp. 


Lawrence 


1,742 


7.1 


52.9 


87.7 


Leominster Hosp. 


Leominster 


1,215 


3.8 


38.4 


85.4 


Lowell General Hosp. 


Lowell 


1,951 


6.6 


37.1 


63.8 


Martha's Vineyard Hosp. 


Oak Bluffs 


137 


7 


37.5 


89.8 


Mary Lane Hosp. 


Ware 


148 


3.4 


54.4 


81.8 


Massachusetts General Hosp. 


Boston 


3,587 


8.1 


27.0 


87.4 


Melrose- Wakefield Hosp. 


Melrose 


1,721 


5.1 


19.1 


89.8 



70 



Table B-15. (continued) Births Characteristics by Licensed Maternity Facility 1 , Massachusetts: 

2003 



Occurrence Low Public Adequate 

Facility Location Births 2 Birthweight 3 Payment for Prenatal Care 5 

(n) (%) Delivery 4 (%) 

(%) 



Mercy Medical Ctr. 


Springfield 


1.406 


4.3 


57.3 


80.3 


Metrowest Medical Ctr.-Framingham 












Union Campus 


Framingham 


2,211 


5.5 


26.3 


91.3 


■ I'll' | | A 1 1 - , ■ •■■ (— i • 111 

Milford-Whitinsville Regional Hosp. 


Milford 


904 


2.9 


16.5 


88.9 


Morton Hosp. 


Taunton 


523 


5.3 


45.2 


76.7 


Mount Auburn Hosp. 


Cambridge 


1,730 


4.5 


15.8 


92.2 


Nantucket Cottage Hosp. 


Nantucket 


96 


5.2 


29.2 


78.9 


Newton-Wellesley Hosp. 


Newton 


3,072 


4.5 


2.4 


77.0 


North Adams Regional Hosp. 


North Adams 


303 


5.0 


41.7 


92.4 


North Shore Birth Ctr. 


Beverly 


88 


0.0 


13.6 


95.5 


North Shore Medical Ctr. - Salem 












Hosp. 


Salem 


1,849 


6.7 


40.2 


73.1 


Saint Vincent Hosp. 


Worcester 


1,842 


4.8 


11.3 


95.4 


Saints Memorial Medical Ctr. 


Lowell 


724 


5.9 


34.2 


83.1 


South Shore Hosp. 


Weymouth 


4,162 


5.7 


9.2 


93.3 


St. Luke's Hosp. 


New Bedford 


1,527 


6.9 


51.8 


80.7 


Sturdy Memorial Hosp. 


Attleboro 


1,056 


4.7 


17.0 


72.3 


Tobey Hosp. 


Wareham 


525 


3.6 


28.2 


52.9 


Tufts-New England Medical Ctr. Hosp. 


Boston 


1,419 


26.1 


33.1 


87.1 


UMass Memorial Medical Center - 












West Campus 


Worcester 


4,473 


11.4 


32.3 


69.4 


Winchester Hosp. 


Winchester 


2,261 


5.3 


5.3 


86.9 


Other Hospitals 




10 


55.6 


42.9 


42.9 


Home Births, En route, Other 




318 


9.7 


20.3 


67.3 



NOTES: All percentages are calculated based on only those births with known values for the characteristic(s) of interest, 
unless otherwise stated. 

1 . A licensed maternity facility is a medical unit licensed by the Commonwealth for the care of women during pregnancy and 
childbirth. 2. See Section Definitions for definition of occurrence births. 3. Less than 2,500 grams (5.5 lbs.) 4. Public 
payment for delivery includes Medicaid/MassHealth, Commonhealth, Medicare, Healthy Start, other government programs, 
and free care. 5. Based on the APNCU Index. 6. The percentages provided in this row are based on occurrence births and 
may differ from data presented elsewhere in this book which are based on resident births. 7. Calculations based on values of 
1-4 for medical characteristics of facilities with less than 200 births are suppressed based on Guidelines for Release of Births 
Data. Center for Health Information, Statistics, Research and Evaluation, Massachusetts Department of Public Health. 



71 



Table B-16A. Birth Characteristics: Occurrence and Resident Births and Infant Deaths, 

Massachusetts Municipalities: 2003 





Occurrence 


Resident 


Low 


Teen Births 


Infant 


Neonatal 


Community 


Births 2 


Births 3 


Birthweight 4 


(15-19 years) 


c 

Deaths 


jtt 

Deaths 6 


STATE TOTAL 


81,309 


80,167 


6,115 


4,639 


383 


285 


a\uw iy uji i 





212 


13 


9 








Ar*tnn 

AM^IUI 1 





224 


12 











n^Uol II ICl 





104 


1 


4 


1 


1 


MUdl I lo 





80 


i 


8 








MydWdl 1 1 





256 


19 


9 


2 


2 


AMIUI U 





5 














A\l 1 luoUui y 


1 


206 


22 


7 








AVI 1 11 Its I Ol 


2 


184 


11 


10 








AM lUUVCI 


2 


293 


18 


3 


2 





mljuii II idi I ^Ody ncduj 




















A rlinntnn 
Ml III iy I 


2 


560 


33 


7 


6 


5 


A chhi imh a m 
nol IUUI I II lea 1 1 1 





62 


1 


2 








Achhu 
nol iuy 





37 





2 








nol ii ictu 


1 


15 


1 











nol lldl IU 





260 


22 


1 


2 


A 

1 


Athnl 

AMI Ivl 


1 


141 


9 


15 


1 


A 
1 


Attlphnrn 


1,056 


622 


A 

46 


A C 

45 


U 


U 


Auhurn 

rvu uui 1 1 


2 


174 


1o 


o 


1 


A 
1 


Avon 


u 


C"7 


_1 


4 
1 


u 


n 
u 


Ayer 


4 
1 


444 
111 


4 A 
14 




U 


u 


Barnstable 


1 ,005 


4b/ 




on 

zy 


D 




Barre 







-7 
( 


1 


u 


n 
u 


Becket 


U 




U 


I 


n 




Bedford 


U 


A A O 

14z 


IO 


O 

Z 


n 
u 


n 


Belchertown 


2 


io» 


iy 


D 


u 


n 


Rpllinoham 


1 


234 


25 


1Z 


4 
1 


1 

1 


Belmont 


A 
1 




14 


A 
\ 


1 


1 

1 


Berkley 


U 


7 A 

/4 


c 



A 
4 


u 


n 


Berlin 





30 


1 


U 


u 


n 
u 


Rprnarrl<itnn 

UCI 1 ICM UolUI 1 





16 


_1 





U 


u 


Dcvct iy 


2,400 


480 


41 


15 


4 
1 


4 
1 


DllltM ltd 


1 


491 


37 


14 




u 


Blackstone 


u 


yo 


1 




n 


o 


Blandford 





18 


1 


5 








Bolton 





52 


i 


1 








Boston 


23,028 


7,823 


700 


573 


48 


37 


Bourne 


1 


234 


20 


12 


3 


2 


Boxborough 





42 


_1 


1 








Boxford 





65 


_1 











Boylston 


1 


53 


6 











Braintree 





410 


24 


6 









72 



Table B-16A. Birth Characteristics: Occurrence and Resident Births and Infant Deaths, 



Massachusetts Municipalities: 2003 





Occurrence 


Resident 


Low 


Teen Births 


Infant 


Neonatal 


Community 


Births 2 


Births 3 


Birthweight 4 


(15-19 years) 


Deaths 5 


Deaths 6 


Brewster 


1 


65 


_i 


2 








Bridgewater 





265 


15 


4 


2 


2 


Brimfield 


1 


23 


1 


3 








Brockton 


2.241 


1,493 


152 


148 


8 


6 


Brookfield 





32 


_1 


2 








Brookline 





691 


51 


1 


2 


2 


Buckland 





21 














Burlington 


1 


290 


16 


1 








Cambridge 


2,897 


1,079 


73 


27 


3 


3 


Canton 





277 


32 


6 


5 


5 


Carlisle 


2 


35 


1 


1 








Carver 





122 


9 


10 








Charlemont 





10 














Charlton 


1 


151 


9 


9 








Chatham 





33 





2 








Chelmsford 


3 


370 


32 


4 


2 


1 


Chelsea 





657 


46 


68 


3 


2 


Cheshire 





30 


_i 


4 








Chester 





15 





3 








Chesterfield 





8 














Chicopee 


2 


600 


41 


59 


4 


2 


Chilmark 


1 


7 














Clarksburg 


1 


9 














Clinton 


1 


192 


13 


14 


1 


1 


Cohasset 





107 


7 











Colrain 


1 


18 














Concord 


1,321 


127 


8 


1 


1 


1 


Conway 





21 


_1 











Cummington 


1 


12 


_1 


1 








Dalton 





77 


9 


6 








Danvers 


1 


232 


20 


7 


2 


1 


Dartmouth 





260 


15 


10 


2 


2 


Dedham 





294 


21 


8 








Deerfield 


1 


37 














Dennis 





93 


_1 


4 


1 


1 


Dighton 





79 


7 


2 








Douglas 





123 


10 


4 








Dover 


1 


64 


5 











Dracut 


1 


355 


31 


13 


2 


1 


Dudley 





119 


12 


2 








Dunstable 


1 


41 


_l 


3 








Duxbury 





161 


9 











East Bridgewater 


1 


150 


10 


2 


1 


1 


East Brookfield 





34 


i 


3 


1 


1 


East Longmeadow 





146 


12 


1 


2 


1 



73 



Table B-16A. Birth Characteristics: Occurrence and Resident Births and Infant Deaths, 

Massachusetts Municipalities: 2003 





Occurrence 


Resident 


Low 


Teen Births 


Infant 


Neonatal 


Community 


Births 


Births 


Birtnweight 


(15-19 years) 


Deaths 


Deaths 


Eastham 





42 


1 


1 








Easthampton 


3 


171 


9 


11 


1 


1 - 


Easton 





236 


10 


5 








Edgartown 





47 


1 





1 





Egremont 


1 


11 














Erving 





20 


1 


2 








Essex 





37 


1 











Everett 


1 


592 


46 


41 


2 


1 


Fairhaven 





169 


6 


12 








rail Kiver 


1,731 


1,262 


123 


163 


7 


5 


Falmouth 


643 


304 


21 


19 


3 


2 


Fitchburg 





587 


49 


75 


3 


1 


Florida 





4 














Foxborough 





206 


16 


2 


1 


1 


Framingham 


2,214 


1,000 


69 


38 


5 


4 


Franklin 


2 


436 


19 


8 


1 


1 


Freetown 





82 


11 


4 








Gardner 


598 


249 


13 


24 


1 


1 


Georgetown 





98 


9 











Gill 





10 





1 








Gloucester 





309 


19 


13 








Goshen 


1 


16 














Gosnold 





2 














(j ration 


3 


239 


20 


5 


2 


2 


Granby 


1 


58 













Granville 





14 








1 


1 


oreai Darnngion 


179 


68 


5 


2 








Greenfield 


467 


192 


18 


24 


1 





Groton 


1 


124 


12 


3 













74 


1 


1 


1 


1 


nacjiey 





50 


7 


1 





u 


nauiax 





80 


14 


10 


3 


2. 


namiiion 





107 


9 











Hampden 





35 


1 


1 


1 


1 


Hancock 





5 














Hanover 





158 


21 


1 


1 


1 


Hanson 





130 


5 


6 








Hardwick 





29 


7 


2 








ndrvaru 





41 


1 





1 


U 


Harwich 





99 


5 


2 








Hatfield 





24 














Haverhill 


1 


897 


49 


53 


2 


1 


Hawley 




















Heath 





5 














Hingham 





270 


20 


3 


2 


2 



74 



Table B-16A. Birth Characteristics: Occurrence and Resident Births and Infant Deaths, 



Massachusetts Municipalities: 2003 





Occurrence 


Resident 


Low 


Teen Births 


Infant 


Neonatal 


Community 


Births 2 


Births 3 


Birthweight 4 


(15-19 years) 


Deaths 5 


Deaths 6 


Hinsdale 


1 


19 


_i 


1 








Holbrook 





118 


9 


4 


1 


1 . 


Hold en 





196 


11 


6 


1 


1 


Holland 





25 


5 


1 








Holliston 


1 


178 


10 











Holyoke 


569 


639 


58 


139 


2 


1 


Hopedale 





73 


1 


1 








Hopkinton 


2 


215 


12 


4 


3 


3 


Hubbardston 





53 


1 


1 








Hudson 


1 


217 


16 


11 


2 


2 


Hull 





116 


6 


1 


2 


2 


Huntington 


2 


29 


_1 


4 








Ipswich 


1 


152 


27 


1 


5 


5 


Kingston 





179 


6 


3 


1 





Lakeville 





112 


7 


3 


1 





Lancaster 





72 


_i 


1 








Lanesborough 





15 





1 








Lawrence 


1,750 


1,373 


117 


236 


8 


7 


Lee 





61 


1 


2 


1 





Leicester 





117 


9 


4 


1 


1 


Lenox 


2 


34 


1 


2 








Leominster 


1,215 


568 


33 


43 


4 


2 


Leverett 


1 


6 














Lexington 


1 


219 


11 











Leyden 





3 














Lincoln 


1 


90 


_j 





1 





Littleton 


1 


116 


8 


4 








Longmeadow 


1 


132 


13 











Lowell 


2,680 


1,696 


178 


174 


20 


14 


Ludlow 


1 


190 


13 


7 








Lunenburg 





90 


9 


3 


1 


1 


Lynn 


2 


1,499 


105 


145 


13 


8 


Lynnfield 





138 


12 


1 - 


3 


3 


Maiden 


2 


801 


60 


29 


3 


3 


Manchester-by-the-Sea 





61 


7 


2 


1 


1 


Mansfield 





384 


33 


6 


1 


1 


Marblehead 





216 


19 


1 








Marion 





50 


_i 


1 








Marlborough 


1 


576 


47 


24 


1 


1 


Marshfield 


1 


327 


13 


4 








Mashpee 





147 


6 


6 


1 


1 


Mattapoisett 





47 


5 


1 








Maynard 


1 


167 


11 


5 








Medfield 


1 


129 


9 











Medford 


4 


584 


47 


15 


1 






75 



Table B-16A. Birth Characteristics: Occurrence and Resident Births and Infant Deaths, 

Massachusetts Municipalities: 2003 





Occurrence 


Rpc irlpnt 


Low 


Teen Births 


Infant 


I lvwl tu lul 


Community 


Births 2 


Births 3 


Birthweight 4 


(15-19 years) 


Deaths 5 


Deaths 6 


Med way 


A 
U 


A 

1 DO 


i 


9 
Z 


n 
U 


A 

u 


Melrose 


1 79*5 


o4Z 




D 


A 


Q 

O . 


Mendon 


KJ 


R1 
D I 


_1 


1 


A 
U 


n 


Merrjmac 


u 


CO 
DO 


_1 


A 
U 


n 


n 
u 


Methuen 


1 "5P.fi 


fi1 9 
D IZ 


fin 


9Q 
zy 


1 


1 


Middleborough 


1 
i 


9 CM 
Z04 


ly 


1 7 


A 
U 


n 


Middlefield 


A 

u 


c 
O 


A 

u 


n 
u 


n 
u 


A 

u 


Middleton 


A 

u 


no 

yo 


_1 


i 


i 
i 


A 

u 


Milford 


yuo 






1 fi 


A 
U 


n 


Millbury 


9 
Z 


1 


1 1 


A 


•1 
1 


1 


Millis 


A 

U 


llo 


7 
/ 


1 


A 
U 


A 
U 


Millville 


U 


Jo 


_1 


•1 
1 


A 
U 


A 
U 


Milton 


A 

U 


zyi 


lo 





1 
I 


A 

I 


Monroe 


a 
U 


A 
\ 


A 

u 


A 
U 


A 
U 


A 

u 


Monson 


A 
U 


OD 


D 


9 
Z 


n 


A 
\J 


Montague 


o 
o 


yo 


c 
O 


m 

I u 


A 

u 


A 
U 


Monterey 


A 
I 


c 
u 


n 


n 


A 
VJ 


A 
\J 


Montgomery 


a 
u 


o 

O 


1 


n 


A 
\J 


A 

u 


Mount Washington 


u 




A 
U 


A 
yj 


A 


n 


Nahant 


z 


/in 


_1 


n 
u 


A 




Nantucket 


mn 
I uu 


l O 1 


14 


9 


A 


n 


Natick 


z 


OU I 


oy 


o 




o 


Needham 


a 


ouu 


1fi 


1 


2 


1 


New Ashford 


a 
\j 


1 


n 


o 


o 


o 


New Bedford 


1 sit 


1 Tl7 


130 


169 


12 


7 


New Braintree 


1 

1 


1Q 


1 


1 


o 





New Marlborough 


A 


10 


n 


o 


o 





New Salem 


o 


7 


n 


o 


o 





Newbury 


n 

u 


fi7 


1 


n 


o 





Newburyport 


7Q7 


ZZ^t 


1 o 


O 


4 


4 


Newton 




7SQ 


S4 


3 


2 


2 


Norfolk 


I 


11ft 

I I o 


fi 


9 


o 


o 


North Adams 


*?n4 


1 ^9 
I oz 


1 VJ 




-| 


1 


North Andover 


n 
u 


jjO 


9^ 
zo 


4 




1 


North Attleboro 


i 


^4^ 


1ft 


fi 
\j 


2 


2 


North Brookfield 


i 


4*3 


1 


o 




1 


North Reading 


n 


1 fin 


IO 


1 

1 


o 





Northampton 


Q1fi 
y 1 D 


91Q 
z i y 


Q 


12 


o 





Northborough 


o 


183 


10 


2 








Northbridge 





213 


16 


9 


2 


1 


Northfield 





23 


1 


2 








Norton 





210 


11 


11 








Norwell 





95 


9 











Norwood 


647 


413 


31 


9 


3 


3 


Oak Bluffs 


137 


35 














76 



Table B-16A. Birth Characteristics: Occurrence and Resident Births and Infant Deaths, 



Massachusetts Municipalities: 2003 





Occurrence 


Resident 


Low 


Teen Births 


Infant 


Neonatal 


Community 


Births 2 


Births 3 


Birthweight 4 


(15-19 years) 


Deaths 5 


Deaths 6 


Oakham 





28 














Orange 





81 


6 


6 








Orleans 





21 


_1 


1 








Otis 





13 














Oxford 





142 


10 


5 


3 


3 


Palmer 


2 


159 


10 


9 


1 





Paxton 





52 


1 











Peabody 


1 


527 


60 


24 


4 


4 


Pelham 





9 














Pembroke 


2 


248 


14 


3 


1 


1 


Pepperell 





171 


13 


7 








Peru 





10 





1 








Petersham 





5 














Phillipston 





17 


jj 


1 








Pittsfield 


790 


527 


44 


72 


4 


2 


Plainfield 


1 


2 














Plainville 





106 


6 


3 








Plymouth 


744 


734 


46 


28 


5 


5 


Plympton 





38 


5 


2 


2 


2 


Princeton 





28 


1 











Provincetown 





15 


_1 











Quincy 


4 


1,181 


75 


43 


6 


5 


Randolph 


1 


412 


40 


10 


3 


3 


Raynham 





151 


10 


5 








Reading 


2 


289 


19 


2 








Rehoboth 





88 


9 


3 








Revere 





706 


51 


50 


1 


1 


Richmond 





11 


1 











Rochester 





53 


_j 


4 








Rockland 





221 


22 


6 








Rockport 





38 


_1 











Rowe 





3 














Rowley 





63 


_1 


1 








Royalston 





14 


_1 











Russell 


2 


24 


1 


1 


1 





Rutland 


1 


98 


6 


3 








Salem 


1,854 


564 


36 


34 


2 


1 


Salisbury 





93 


_i 


10 








Sandisfield 





6 


1 











Sandwich 


1 


207 


8 


4 








Saugus 





295 


22 


6 








Savoy 





7 


1 











Scituate 


2 


239 


26 


3 








Seekonk 


2 


125 


9 


3 








Sharon 





162 


11 












77 



Table B-16A. Birth Characteristics: Occurrence and Resident Births and Infant Deaths, 

Massachusetts Municipalities: 2003 





Occurrence 


Resident 


Low 


Teen Births 


Infant 


Neonatal 


isornmumiy 


Rirthc 2 
D Ii Ii lb 


Rirthc 3 

Dim is 


R i i-fr Hia/ a i rt h 
Diiuiwyiyiii 




rioafhc' 


ueains 


onemeia 


1 


27 


1 











Shelburne 


1 


23 





1 








Sherborn 





43 


6 











Chirlnn 

oniney 





81 


10 


1 


1 


1 . 


onrewsDury 


1 


439 


39 


5 








Shutesbury 


3 


17 





1 








oornersei 





140 


11 


4 








oonicr vine 


6 


924 


80 


46 


2 


2 







121 


i 


4 








oouinarTipion 


1 


53 




5 








oOuinDorougn 





132 


10 


1 


2 


2 


oouuiur luyt? 


462 


270 


14 


37 


4 


1 


0/-vi ithvA/ir'L' 
OOUU IWItr 





84 


6 


5 


1 


1 


optJi iCtJI 


1 


122 


1 


9 








opt ii ly i iciu 


5,699 


2,423 


230 


479 


11 


6 


old ill ly 





93 


5 











Qtru-^L'hriHno 
OlUL.r\UI ILiyc 





11 


1 











OlU>l ICl la 1 1 1 





260 


16 


3 


2 


1 


oiuuyiuuii 





344 


21 


10 


3 


1 


OIUW 


2 


73 


7 





1 


1 


Oiui Ui luy c 





120 


5 





1 





ouuuuiy 


1 


219 


11 











OUt (Ucl lot IU 





42 


6 


2 








OUllUI 1 





99 


8 


3 





U 


OWdl 1 ipoLULl 


1 


154 


16 


2 


1 


U 


OWdl loco 


1 


155 


15 


10 





U 


I dui uui I 


524 


742 


63 


58 


4 


4 


Tpmnlptnn 


2 


70 


6 


Q 

o 




£ 


Tp\A/k<Nhi irv 

1 C V»T\OUUI y 


1 


370 


21 


Q 

o 


U 


n 
u 


i louui y 


1 


47 


1 


2 


(J 


u 


TnllanH 





3 





U 


U 


u 


TrirwfiplH 

1 ^JJJolICIU 





56 


1 


(J 


U 


u 


1 UWI IOCI l\J 


2 


119 


6 


b 


U 


u 


1 lulu 


1 


16 





U 


U 


u 


Tv/nn<;rv»rni inh 





140 


7 


b 


U 


u 


Tv/rinnh^m 
i yi ii iyi ioi 1 1 





2 





U 


U 


u 


1 Inton 

UfJIUI 1 


1 


94 


8 


Z 


U 




\j au\ luyc 





159 


5 


2 




i 


Wakefield 


U 


Ol O 


OI 




o 
c 


2 


Wales 





27 


i 


1 








Walpole 


1 


297 


16 


4 








Waltham 


3 


736 


63 


26 


4 


4 


Ware 


149 


121 


8 


18 


1 





Wareham 


526 


247 


16 


21 


1 





Warren 





74 


5 


7 


1 


1 



78 



Table B-16A. Birth Characteristics: Occurrence and Resident Births and Infant Deaths, 

Massachusetts Municipalities: 2003 





Occurrence 


Resident 


Low 


Teen Births 


Infant 


Neonatal 


Community 


Births 2 


Births 3 


Birthweight 4 


(15-19 years) 


Deaths 5 


Deaths 6 


Warwick 





6 











o 


Washington 





7 








o 


o 


Watertown 


2 


414 


33 


5 


o 


o 


Wayland 


1 


131 


10 





1 


o 


Webster 


1 


236 


14 


14 


o 


o 


Wellesley 


122 


318 


15 





1 


1 


Wellfleet 





33 


_1 





o 


o 


Wendell 





4 





2 





o 


Wenham 





42 




1 


o 


o 


West Boylston 





60 


_1 


3 


o 


o 


West Bridgewater 





85 


_1 


1 


o 


o 


West Brookfield 





32 


_1 


4 


o 


o 


West Newbury 





29 


_i 








o 


West Springfield 





313 


18 


23 


3 


3 


West Stockbridge 





11 














West Tisbury 





22 


_1 


1 








Westborough 


4 


243 


17 


5 


1 


1 


Westfield 


2 


436 


26 


24 








Westford 





286 


25 











Westhampton 





21 


j 


1 








Westminster 





68 


_1 


3 








Weston 





92 


8 


1 


1 





Westport 





124 


12 


10 


1 


1 


Westwood 





179 


16 





1 


1 


Weymouth 


4,170 


729 


60 


28 


6 


5 


Whately 





7 





1 








Whitman 





189 


16 


10 








Wilbraham 





122 


19 


2 








Williamsburg 


1 


26 


_1 


3 








Williamstown 


1 


51 


_1 


1 








Wilmington 





296 


19 


3 








Winchendon 


1 


109 


9 


9 








Winchester 


2,264 


250 


22 


2 








Windsor 





4 














Winthrop 





176 


8 


3 








Woburn 





489 


32 


14 


3 


2 


Worcester 


6,323 


2,588 


233 


263 


11 


8 


Worthington 


1 


11 





1 








Wrentham 


1 


135 


8 


2 


1 


1 


Yarmouth 





220 


8 


14 









1 . Values of 1 -4 for medical characteristics of communities with less than 200 births are suppressed based on Guidelines for Release of Birth Data, 
Center for Health Information. Statistics. Research and Evaluation, Massachusetts Department of Public Health 2. Births occurring in a geographical 
place (state, city/town) regardless of the residency of the mother. 3. Births to mothers who report their usual place of residence as a particular 
geographical place (state, or city/town). 4. Less than 2,500 grams (5.5 lbs.). 5. Death of a child whose age is less than one year. 6. Death of a child 
whose age is less than 28 days. 



79 



Table B-16B. Birth Characteristics, Occurrence and Resident Births and Infant 

Deaths by County, Massachusetts: 2003 

Occurrence 

Births 1 Resident Births 2 Deaths 



Low Teen Births 



County Name 




Number 


Birthweight 3 


(15-19 years) 


Infant 4 


Neonatal 5 


STATE TOTAL 


81,309 


80,167 


6,115 


4,639 


383 


285 


Barnstable 


1,652 


1,996 


110 


96 


13 


10 


Berkshire 


1,281 


1,284 


98 


122 


6 


3 


Bristol 


4.848 


6.669 


547 


534 


30 


23 


Dukes 


139 


160 


7 


3 


1 





Essex 


8,199 


9.555 


735 


599 


52 


39 


Franklin 


478 


683 


43 


52 


1 





Hampden 


6,279 


5,777 


485 


774 


29 


18 


Hampshire 


1,081 


1,299 


77 


77 


2 


1 


Middlesex 


16,225 


18.469 


1,402 


572 


80 


59 


Nantucket 


100 


151 


14 


2 








Norfolk 


4,952 


8,353 


563 


168 


38 


33 


Plymouth 


3,518 


6,305 


485 


301 


30 


24 


Suffolk 


23.028 


9,362 


805 


694 


52 


40 


Worcester 


9,529 


10,104 


744 


645 


49 


35 



1 . Births occurring in a geographical place (state, city/town) regardless of the residency of the mother. See Section Definitions for more 
details. 2. Births to mothers who report their usual place of residence as a particular geographical place (state, or city/town). See Section 
Definitions for more details. 3. Less than 2,500 grams (5.5 lbs.). 4. Death of a child whose age is less than one year. 5. Death of a child 
whose age is less than 28 days. 



80 



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81 



DEATHS 



SECTION C 



DEATHS 



The number of Massachusetts resident deaths decreased from 2002 (56,881 deaths) to 
2003 (56,194 deaths). The 2003 crude death rate of 872.2 per 100,000 population was 
slightly lower than the 2002 crude death rate of 885.7. As with live births, Massachusetts 
resident deaths include all deaths to Massachusetts residents regardless of the state in 
which the deaths occurred. Most data presented in this section are resident data. 
Occurrence data are used only for medical examiner data. 

DEATHS BY RACE/ETHNICITY 

From 2002 to 2003, the number of deaths by race/ethnicity remained relatively constant 
with White non-Hispanic residents comprising 92.6% of total deaths in Massachusetts. 
Black non-Hispanic deaths totaled 4.2% of total deaths, Hispanic deaths 2.0%, Asian non- 
Hispanic deaths 1.0%, and other and unknown race deaths 0.2%. 

Prior to 1989, only a race question was included on death certificates. A separate item on 
Hispanic origin was added to the death record beginning January 1, 1989. This item asks 
whether the decedent was of Hispanic origin. If answered affirmatively, then specific 
Hispanic origin (e.g., Puerto Rican, Dominican, Cuban, etc.) is requested. 

DEATHS BY AGE 



Persons 75 years of age or older accounted for 63.35% of all resident deaths. The percent 
of deaths to residents in this age group vary widely by sex and race/ethnicity. 









% OF DEATHS 75 






% OF DEATHS 


YEARS AND 


SEX 


RACE 


UNDER AGE 75 


OLDER 


MALE 


WHITE NON-HISPANIC 


44.11 


55.89 




BLACK NON-HISPANIC 


69.77 


30.23 




HISPANIC 


84.01 


15.99 




ASIAN 


60.50 


39.50 




OTHER/UNKNOWN 


84.62 


15.38 




TOTAL 


46.57 


53.43 


FEMALE 


WHITE NON-HISPANIC 


26.12 


73.88 




BLACK NON-HISPANIC 


54.63 


45.37 




HISPANIC 


64.33 


35.67 




ASIAN 


47.69 


52.31 




OTHER/UNKNOWN 


63.64 


36.36 




TOTAL 


28.02 


71.98 


TOTAL 


WHITE NON-HISPANIC 


34.38 


65.62 




BLACK NON-HISPANIC 


62.42 


37.58 




HISPANIC 


76.02 


23.98 




ASIAN 


54.75 


45.25 




OTHER/UNKNOWN 


72.88 


27.12 




TOTAL 


36.65 


63.35 



83 



DEATHS BY PLACE OF OCCURRENCE 



Between 2002 and 2003, there was little variation in the sites where deaths occurred. The 
data are presented below: 



SITE 


% OF DEATHS 
2003 


% OF DEATHS 
2002 


HOSPITAL 


44.4 


44.7 


NURSING OR REST HOME 


30.1 


30.3 


AT HOME 


22.1 


21.6 


EN ROUTE TO HOSPITAL OR DEAD ON ARRIVAL 


1.6 


1.6 


OTHER AND UNKNOWN 1 


1.8 


1.8 


TOTAL 


100.0 


100.0 



DEATHS BY CAUSE 

Cause of death statistics in this report are based on the Tenth Revision of the International 
Classification of Diseases (ICD-10). The methodology of coding cause of death from death 
certificates is consistent nationally, using the Automated Classification of Medical Entities 
(ACME) developed by the National Center for Health Statistics (NCHS). The ACME system 
requires every disease or condition mentioned on the record to be coded. The underlying 
cause is then selected by a computer program which incorporates the ICD-10 rules and 
conventions. Cause of death information in this report is based on underlying cause, 
except where otherwise noted. 

The leading causes of death differed somewhat by race and ethnicity in 2003, as in 
previous years. Nine of the ten leading causes of death for White non-Hispanics were 
chronic conditions (e.g., heart disease, cancer, stroke, respiratory illness, and diabetes) 
which usually afflict older people. For Asian non-Hispanics, perinatal conditions and 
suicide were among the top ten leading causes of death. For Hispanics, AIDS/HIV-related 
diseases, perinatal conditions, homicide and injuries of undetermined intent were among 
the leading causes of death in 2003. 



1 Other and Unknown includes prison or other institutions and all other places. 



84 



ACQUIRED IMMUNE DEFICIENCY SYNDROME (AIDS) 



In 2003, 226 Massachusetts residents died from AIDS and HIV-related illnesses. This 
represents a 1.3% decrease from 2002 and the overall age adjusted rate of death, 3.5 
deaths per 100,000 people, was the same as in 2002. AIDS/ HIV related disease still ranked 
in the top 10 causes of death for Hispanics and Black non-Hispanics. 

DEATHS CERTIFIED BY MEDICAL EXAMINERS 

The total number of deaths certified by medical examiners increased slightly from 3,994 in 
2002 to 4,01 1 in 2003. Of the deaths certified by medical examiners, 38.6% were reported 
as a result of natural causes. The percentage of deaths due to natural causes (i.e., non- 
injury related causes) certified by medical examiners varies somewhat by county, from a 
high of 71.4% in Dukes County to a low of 31.4% in Suffolk County. Suffolk County had the 
greatest percentage of deaths (31.5%) that was referred to medical examiners, while the 
highest number of deaths referred to the medical examiner was in Middlesex County with 
2,631 deaths. 

DEFINITIONS IMPORTANT FOR THIS SECTION INCLUDE: 



AGE-ADJUSTED RATE 

A procedure for adjusting rates, designed to minimize the effects of differences in age 
distribution when comparing rates for different populations. This procedure is 
accomplished by the computational process known as age standardization, whereby 
mortality statistics are adjusted to a reference population. For this publication, the 
reference population is the 2000 US population, the same used by the National Center for 
Health Statistics. The result of the process is a summary index that can be used to 
compare rates of different populations throughout the nation and over time. 

COMMUNITY HEALTH NETWORK AREAS (CHNA) 

The Department of Public Health, in collaboration with health service providers, coalition 
members, and other interested citizens, has designated 27 geographic areas for 
community health planning. It is the Department's intention to foster in each of these areas 
the development of Community Health Networks: a consortia of health care providers, 
human service agencies, schools, churches, youth, parents, elders, advocacy groups, and 
individual consumers to address the health needs of the community. These community 
coalitions will participate in monitoring outcomes and the progress of strategies and 
responses to those health needs. The data published in this edition reflect the new 
definitions of CHNAs instituted in January 1997. 

A Community Health Network Area (CHNA) is defined as an aggregation of cities and 
towns. It is hoped that the Networks will mobilize around key health issues impacting the 
community, promote prevention efforts, enhance access to health care, provide 
opportunities for more collaboration among agencies, and create a client-centered, 
outcome-oriented health service delivery system. Community Health Networks will also 
promote efficiency in service delivery by working to reduce duplication and overlap, and by 
identifying gaps in service. 



85 



DEATH CERTIFICATE 



A vital record signed by a licensed physician that includes cause of death, decedent's 
name, sex, birth date, place of residence, and place of death. 



INTERNATIONAL CLASSIFICATION OF DISEASES, TENTH REVISION 

The International Classification of Disease (ICD) classifies cause of death information for 
statistical purposes. The ICD was first used in 1900 and has since been revised about 
every 10 years. The Tenth Revision is used to code mortality data beginning with 1999. 



MISER 

The Massachusetts Institute for Social and Economic Research. This research institute, 
located at the University of Massachusetts in Amherst, produced the official population 
estimates and projections for the Department of Public Health through 1998. 



OCCURRENCE DEATH 

Occurrence deaths include all deaths that occur within the state, including deaths of non- 
residents. An interstate exchange agreement among the 50 states, Canada, Puerto Rico, 
Guam, the Virgin Islands, and the District of Columbia provides for exchanges of copies of 
birth and death records. These records are used for statistical purposes only, and allow 
each state or province to track the births and deaths of residents. 



RACE 

For death records, race is provided by the death record informant (for example, spouse or 
next of kin). 



RESIDENT DEATH 

The death of a person whose usual place of residence or permanent address (as reported 
by the informant) is in one of the 351 cities or towns of Massachusetts, regardless of where 
the death took place. Unless otherwise noted, all data in this publication are resident data. 
An interstate exchange agreement among the 50 states, Canada, Puerto Rico, Guam, the 
Virgin Islands, and the District of Columbia provides for exchange of copies of birth and 
death records. These records are used for statistical purposes only, and allow each state 
or province to track the births and deaths of residents. 



86 



UNDERLYING CAUSE OF DEATH 



The underlying cause of death is: 1.) the disease or injury that initiated the series of events 
leading to death, or 2.) the circumstances of the unintentional or intentional injury that 
resulted in the death. See the Appendix for the Death Certificate. 



RATES IMPORTANT FOR THIS SECTION INCLUDE: 



AGE-SPECIFIC Number of Resident Deaths in Specific Age Group x 100,000 

DEATH RATE Total Population of Specific Age Group 



CAUSE-SPECIFIC Number of Resident Deaths for a Specific Cause x 100.000 
DEATH RATE Total Population 



CRUDE DEATH Number of Resident Deaths in a Year x 100,000 

RATE Total Population 



87 



ICD-10 and ICD-9 Codes Used in this Publication 

(Sorted by ICD-10 Codes) 



Cause of Death 



ICD-10 Code 



ICD-9 Code 



Infectious and parasitic diseases 

Septicemia 

Human Immunodeficiency Virus (HIV) disease 

Cancer (Malignant Neoplasms) 

of esophagus 
of stomach 

of colon, rectum, rectum and anus 
of pancreas 

of trachea, bronchus and lung 
of female breast 
of cervix uteri 

of corpus uteri and uterus, part unspecified 
of ovary 
of prostate 

of kidney and renal pelvis 
of bladder 

of meninges, brain & other parts of central nervous 
system 

Hodgkin's Disease 
Non-Hodgkin's lymphoma 
Leukemia 

Multiple myeloma and immunoproliferative neoplasms 
Diabetes Mellitus 
Alzheimer's disease 
Heart Disease 

Stroke (Cerebrovascular disease) 
Influenza and pneumonia 
Chronic lower respiratory diseases 1 
Chronic liver disease and cirrhosis 
Nephritis 

Congenital malformations, deformations, and 
chromosomal abnormalities 

Certain conditions originating in the perinatal period 
(Perinatal Conditions) 

Signs and symptoms 

Sudden infant death syndrome (SIDS) 
External causes of injuries and poisonings 
(intentional, unintentional and of undetermined intent) 
Accidents (Unintentional Injuries) 
Motor Vehicle-related injuries 



Unintentional non-transport injuries 
Suicide 
Homicide 

Injuries of undetermined intent 



A00-B99 
A40-A41 
B20-B24 

C00-C97 

C15 

C16 

C18-C21 
C25 

C33-C34 

C50 

C53 

C54-C55 

C56 

C61 

C64-C65 
C67 

C70-C72 
C81 

C82-C85 
C91-C95 
C88, C90 

E10-E14 

G30 

I00-I09, 111, 113, 120-151 

I60-I69 

J10-J18 

J40-J47 

K70, K73-K74 

N00-N07, N17-N19, N25-N27 
Q00-Q99 



P00-P96 
R00-R99 

R95 

V01-Y89 

V01-X59, Y85-Y86 
V02-V04, V09.0, V09.2, V12-V14, 
V19.0-V19.2, V19.4-V19.6, V20- 
V79, V80.3-V80.5, V81.0-V81.1, 
V82.0-V82.1, V83-V86, V87.0- 
V87.8, V88.0-V88.8, V89.0, V89.2 

W00-X59, Y86 
X60-X84, Y87.0 
X85-Y09, Y87.1 
Y10-Y34,Y87.2,Y89.9 



001-139 
038 

042-044 

140-208 

150 

151 

153-154, 159.9 

157 

162 

174 

180 

179,182 

183.0 

185 

189.0-189.1 
188 

191-192 
201 

200, 202 (except 202.4) 

202.4, 204-208 

203 

250 

331.0 

390-398, 402, 404-429 

430-438 

480-487 

490-496 

571 

580-589 
740-759 



760-779 

780-797, 798.1-798.9, 799 
798.0 

E800-E999 

E800-E949 
E810-E825 



E850-E869, E880-E928, 

E929.2-E929.9 

E950-E959 

E960-E969 

E980-E989 



1. The title of this cause of death has changed between ICD-10 and ICD-9. Chronic Lower Respiratory Disease (ICD-10 title) corresponds to Chronic 
Obstructive Pulmonary Disease (COPD) (ICD-9 title). 



88 



ICD-10 and lCD-9 Codes Used in this Publication 
(Sorted by Cause of Death) 



Cause of Death 

Alzheimer's Disease 

Cancer (Malignant Neoplasms) 
of bladder 
of cervix uteri 

of colon, rectum, rectum and anus 

of corpus uteri and uterus, part unspecified 

of esophagus 

of female breast 

Hodgkin's Disease 

of kidney and renal pelvis 

Leukemia 

of meninges, brain & other parts of central nervous system 

Multiple myeloma and immunoproliferative neoplasms 

Non-Hodgkins lymphoma 

of ovary 

of prostate 

of stomach 

of pancreas 

of trachea, bronchus and lung 

Certain conditions originating in the perinatal period 
(Perinatal Conditions) 

Chronic liver disease and cirrhosis 
Chronic lower respiratory diseases 1 
Congenital malformations, deformations, and 
chromosomal abnormalities 

Diabetes Mellitus 

External causes of injuries and poisonings 
(intentional, unintentional and of undetermined intent) 

Homicide 

Injuries of undetermined intent 
Suicide 

Accidents (Unintentional Injuries) 

Motor Vehicle-related injuries 



Unintentional non-transport injuries 
Heart Disease 

Infectious and parasitic diseases 

Human Immunodeficiency Virus (HIV) disease (AIDS) 
Septicemia 

Influenza and pneumonia 

Nephritis 

Stroke (Cerebrovascular disease) 

Signs and symptoms 

Sudden infant death syndrome (SIDS) 



ICD-10 Code 

G30 

C00-C97 

C67 

C53 

C18-C21 

C54-C55 

C15 

C50 

C81 

C64-C65 

C91-C95 

C70-C72 

C88, C90 

C82-C85 

C56 

C61 

C16 

C25 

C33-C34 



P00-P96 
K70, K73-K74 
J40-J47 

Q00-Q99 

E10-E14 
V01-Y98 

X85-Y09, Y87.1 
Y10-Y34,Y87.2,Y89.9 
X60-X84, Y87.0 
V01-X59 

V02-V04, V09.0, V09.2, V12- 
V14, V19.0-V19.2, V19.4-V19.6, 
V20-V79, V80.3-V80.5, V81.0- 
V81.1. V82.0-V82.1, V83-V86. 
V87.0-V87.8, V88.0-V88.8, 
V89.0, V89.2 
W0O-X59, Y86 

I00-I09, 111, 113, 120-151 

A00-B99 
B20-B24 
A40-A41 

J10-J18 

N00-N07, N17-N19, N25-N27 

I60-I69 

R00-R99 

R95 



ICD-9 Code 

331.0 

140-208 

188 

180 

153-154, 159.9 

179,182 

150 

174 

201 

189.0-189.1 
202.4, 204-208 
191-192 
203 

200, 202 (except 202.4) 

183.0 

185 

151 

157 

162 

760-779 
571 

490-496 

740-759 
250 

E800-E999 

E960-E969 
E980-E989 
E950-E959 
E800-E949 



E810-E825 

E850-E869, E880-E928, 
E929.2-E929.9 

390-398, 402, 404-429 

001-139 
042-044 
038 

480-487 
580-589 
430-438 

780-797, 798.1-798.9, 799 
798.0 



1 . The title of this cause of death has changed between ICD-10 and ICD-9. Chronic Lower Respiratory Disease (ICD-10 title) corresponds to Chronic 
Obstructive Pulmonary Disease (COPD) (ICD-9 title). 



89 



ICD-10 Injury Codes Used in this Publication 



Cause of Death 



ICD-10 Code 



Suicide 

Poisoning 

Hanging, strangulation or suffocation 
Firearm 

Other and unspecified 

Homicide 

Firearm 

Cut or pierce 

Other and unspecified 

Unintentional Injuries (Accidents) 
Falls 

Hanging, strangulation or suffocation 

Drowning or submersion 

Smoke, fire and flames 

Poisoning 

Firearm 

Motor Vehicle-related 



Injury to pedestrian 
Injury to pedal cyclist 

Injury to motorcyclist 
Injury to occupant 



Other and unspecified 
Other and unspecified 

Events of Undetermined Intent 

Poisoning 

Drowning or submersion 
Other and unspecified 

Legal Intervention 

Firearm 

Adverse Effects 

Drugs 

Medical Care 



X60-X84, Y87.0 

X60-X69 

X70 

X72-X74 
Residual 

X85-Y09, Y87.1 

Y93-Y95 

X99 

Residual 

V01-X59, Y85-Y86 

W00-W19 

W75-W84 

W65-W74 

X00-X19 

X40-X49 

W32-W34 

V02-V04, V09.0, V09.2. V12- 
V14, V19.0-V19.2, V19.4- 
V19.6, V20-V79, V80.3- 
V80.5, V81.0-V81.1, V82.0- 
V82.1, V83-V86, V87.0- 
V87.8, V88.0-V88.8, V89.0, 
V89.2 

V02-V04, V09.0, V09 
V12-V14, V19.0, V19.2, 
V19.4, V19.5, V19.6 
V20-V29 

V30-V79, V80.3, V80.4, 
V80.5, V81.0.V81.1, V82.0, 
V82.1, V83-V86 
Residual 
Residual 

Y10-Y34, Y87.2, Y89.9 

Y10-Y19 

Y21 

Residual 

Y35.-Y36, Y89.0, Y89.1 
Y35.0 

Y40-Y59, Y60-Y84, Y88 
Y40-Y59, Y88.0 
Y60-Y84, Y88.1, Y88.2, 
Y88.3 



90 



ICD-10 Poisoning Codes Used in this Publication 



Manner of Death 


ICD-10 Code 




X40-X49, X60-X69, X85-X90, Y87.0, 


All Poisoning Deaths 


Y10-Y19] Y35.2 


Narcotics and psychodysleptics 


X42, X62, Y12 


Other and unspecified drugs, medicaments, biological substances 


X44, X64, X89, Y14 


Antiepileptic, sedative-hypnotic, antiparkinsonism & psychotropic 


X41, X61, Y11 


Gases and vapours 


X47, X67, X86, X88, Y17, Y35.2 


Nonopioid analgesics, antipyretics & antirheumatics 


X40, X60, Y10 


Alcohol 


X45, X65, Y15 


Organic solvents and halogenated hydrocarbons 


X46, X66, Y16 


Other drugs acting on autonomic nervous system 


X43, X63, Y13 


Other and unspecified chemicals and noxious substances 


Remaining causes 



91 



Table A6. ICD-10 Codes for Selected Healthy People 2010 Mortality Objectives Used in 

this Publication 

(Sorted by Objective Number) 



Objective 
Number 


Cause of Death 


ICD-10 Identifying Codes 


3-1 


Cancer (all sites) 


C00-C97 


3-2 


Lung cancer 


C33-C34 


3-3 


Female breast cancer 


C50 


3^ 


Uterine Cervix cancer 


C53 


3-5 


Colorectal cancer 


C18-C21 


3-6 


Oropharyngeal cancer 


C00-C14 


O 1 


riUoldlc UCH lUcl 


PR1 

OU 1 


3-8 


Malinnant mplanoma 


C43 


12-1 


Coronarv heart disease 


111, I20-I25 


12-7 


Stroke 


I60-I69 


13-14 


HIV infection 


B20-B24 


15-3 


Firearm-related deaths 


W32-W34, X72-X74, Y22-Y24. Y93-Y95 


15-8 


Poisonina 


X40-X49, X60-X69, X85-X90, Y10-Y19, 
Y35.2 


15-9 


Hanging, strangulation or suffocation 


W75-W84, X70, X91, Y20 


15-13 


Unintentional injuries (Accidents) 


V01-X59, Y85-Y86 


15-15 


Motor vehicle-related 


V02-V04, V09.0, V09.2, V12-V14, V19.0- 
V19.2, V19.4-V19.6, V20-V79, V80.3- 
V80.5, V81.0-V81.1, voZ.\)-voZ.\ , Voo- 
V86, V87.0-V87.8, V88.0-V88.8, V89.0, 
V89.2 


15-25 


Residential fire deaths 


X00, X02 


15-27 


Falls 


W00-W19 


15-29 


Drownings 


W65-W74, X71, X92, Y21, V90, V92 


15-32 


Homicides 


X85-Y09, Y87.1 


16-1f 


Birth defects 


Q00-Q99 


16-1g 


Congenital heart and vascular defects 


Q20-Q24 


16-1h 


Sudden infant death syndrome (SIDS) 


R95 


18-1 


Suicide 


X60-X84, Y87.0 


24-1 


Asthma 


J45-J46 


26-1 


Motor-vehicle crash deaths 


V02-V04, V09.0, V09.2, V12-V14, V19.0- 
V19.2, V19.4-V19.6, V20-V79, V80.3- 
V80.5, V81.0-V81.1, V82.0-V82.1, V83- 
V86, V87.0-V87.8, V88.0-V88.8, V89.0, 
V89.2 


26-2 


Cirrhosis 


K74 


26-3 


Drug induced deaths 


F11.0-F11.5, F11.7-F11.9, F12.0-F12.5, 
F12.7-F12.9, F13.0-F13.5, F13.7-F13.9, 
F14.0-F14.5, F14.7-F14.9, F15.0-F15.5, 
F15.7-F15.9, F16.0-F16.5, F16.7-F16.9, 
F17.0, F17.3-F17.5, F17.7-F17.9, F18.0- 
F18.5, F18.7-F18.9, F19.0-F19.5, F19.7- 
F19.9,X40-X44,X60-64, X85.Y10-Y14 



These Healthy People 2010 objectives use underlying cause of death data. 



92 



Table A6. ICD-10 Codes for Selected Healthy People 2010 Mortality Objectives Used in 

this Publication 

(Sorted by Objective Number) 



Objective 
Number 



Cause of Death 



ICD-10 Identifying Codes 



3-1 
3-2 
3-3 
3^ 
3-5 
3-6 
3-7 
3-8 
12-1 

12- 7 

13- 14 
15-3 
15-8 

15-9 

15-13 

15-15 



15-25 
15-27 
15-29 

15- 32 

16- 1f 
16-1g 
16-1h 
18-1 
24-1 
26-1 



26-2 
26-3 



Cancer (all sites) 

Lung cancer 

Female breast cancer 

Uterine Cervix cancer 

Colorectal cancer 

Oropharyngeal cancer 

Prostate cancer 

Malignant melanoma 
Coronary heart disease 
Stroke 
HIV infection 
Firearm-related deaths 
Poisoning 

Hanging, strangulation or suffocation 
Unintentional injuries (Accidents) 
Motor vehicle-related 



Residential fire deaths 
Falls 

Drownings 
Homicides 
Birth defects 

Congenital heart and vascular defects 
Sudden infant death syndrome (SIDS) 
Suicide 
Asthma 

Motor-vehicle crash deaths 



Cirrhosis 

Drug induced deaths 



C00-C97 
C33-C34 
C50 
C53 

C18-C21 
C00-C14 
C61 
C43 

111, 120-I25 

I60-I69 

B20-B24 

W32-W34, X72-X74, Y22-Y24, Y93-Y95 

X40-X49, X60-X69, X85-X90, Y10-Y19, 
Y35.2 

W75-W84, X70, X91, Y20 
V01-X59, Y85-Y86 

V02-V04, V09.0, V09.2, V12-V14, V19.0- 
V19.2, V19.4-V19.6, V20-V79, V80.3- 
V80.5, V81.0-V81.1, V82.0-V82.1, V83- 
V86, V87.0-V87.8, V88.0-V88.8, V89.0, 
V89.2 

X00, X02 

WOO- W 19 

W65-W74, X71, X92, Y21, V90, V92 

X85-Y09, Y87.1 

Q00-Q99 

Q20-Q24 

R95 

X60-X84, Y87.0 
J45-J46 

V02-V04, V09.0, V09.2, V12-V14, V19.0- 
V19.2, V19.4-V19.6, V20-V79, V80.3- 
V80.5, V81.0-V81.1, V82.0-V82.1, V83- 
V86, V87.0-V87.8, V88.0-V88.8, V89.0, 
V89.2 

K74 

F11.0-F11.5, F11.7-F11.9, F12.0-F12.5, 
F12.7-F12.9, F13.0-F13.5, F13.7-F13.9, 
F14.0-F14.5, F14.7-F14.9, F15.0-F15.5, 
F15.7-F15.9, F16.0-F16.5, F16.7-F16.9, 
F17.0, F17.3-F17.5, F17.7-F17.9, F18.0- 
F18.5, F18.7-F18.9, F19.0-F19.5, F19.7- 
F19.9,X40-X44,X60-64, X85.Y10-Y14 



These Healthy People 2010 objectives use underlying cause of death data. 



93 



Figure C-1 



Daily Death Statistics 
Massachusetts: 2003 

Every day in 2003, residents of Massachusetts experienced on average: 




8 Injury Deaths 



1 Motor Vehicle Death 


1 Suicide Death 


6 Other Intentional & 






Unintentional Injury Deaths 



'includes 33 deaths due to other causes 



94 



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Figure C-2 




Table C-2. Years of Life Remaining 1 , Massachusetts: 2003 

White non- Black non- Hispanic White non- Black non- Hispanic 



At Age: 


All 


Females 


Hispanic 
Females 


Hispanic 
Females 


Females 


Males 


Hispanic 
Males 


Hispanic 
Males 


Males 


Birth 


78.5 


80.9 


81.1 


75.6 


84.0 


75.8 


76.2 


69.3 


76.8 


1 year old 


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80.3 


80.4 


75.8 


83.4 


75.2 


75.5 


69.3 


76.4 


5 years old 


74.0 


76.3 


76.4 


71.9 


79.5 


71.2 


71.5 


65.4 


72.5 


15 years old 


64.0 


66.4 


66.5 


62.0 


69.6 


61.3 


61.6 


55.6 


62.6 


25 years old 


54.3 


56.6 


56.7 


52.2 


59.8 


51.8 


52.0 


46.4 


53.3 


35 years old 


44.7 


46.8 


46.9 


42.6 


50.1 


42.3 


42.5 


37.4 


44.1 


45 years old 


35.4 


37.3 


37.4 


33.5 


40.7 


33.1 


33.2 


28.6 


35.3 


55 years old 


26.5 


28.2 


28.2 


25.5 


31.5 


24.5 


24.6 


21.2 


27.6 


65 years old 


18.6 


19.9 


19.9 


18.0 


23.2 


16.8 


16.9 


14.4 


20.3 


75 years old 


11.6 


12.5 


12.4 


11.5 


16.0 


10.1 


10.1 


8.8 


14.3 


85 years old 


6.3 


6.7 


6.7 


6.2 


11.7 


5.3 


5.2 


6.0 


8.9 



1. Years of Life Remaining calculated using the Greville Abridged Life Table Method, (source: Dublin LI. Length of Life - A Study of the Life 
Table. Ronald Press Co. New York. 1949.) DPH 2000 Preliminary Population Estimates (released January 2002) are used as the denominator. 



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98 



Table C-4A. Leading Causes of Death 1 , Numbers and Age-Specific Rates by Gender, 








Massachusetts: 2003 














Total 


Female 


Male 




Age 


Cause of death 


Number 


Rate 3 


Number 


Rate 3 


Number 


Rate 3 


1-14 years 


TOTAL 


149 


12.6 


64 


11.1 


85 


14 1 




Unintentional Injuries 


32 


2.7 


12 


2.1 


20 


o.o 




Cancer 


23 


1.9 


9 


1.6 


14 


2.3 




Congenital Malformations 


14 


1.2 


5 


0.9 


9 


1.5 




Signs and Symptoms 


8 


0.7 


6 


1.0 


o 
2 


6 


15-24 years 


TOTAL 


490 


59.8 


132 


32.1 


358 


87.5 


Unintentional Injuries 


•ICC 


20.1 


A O 

42 


10.2 


123 


30.1 




Inii irip<^ nf 1 InriAf Arminprl Intent 

IIIJUIICO VJI \jl IUCICI 1 1 HI ICvJ II lid H 


89 


10.9 


21 


5.1 


68 


16.6 




norniciae 


47 


5.7 


3 


6 


AA 


10.8 




Suicide 


46 


5.6 


5 


1.2 


41 


10.0 


25 - 44 years 


TOTAL 


2,484 


124.8 


868 


85.8 


1,616 


165!2 




Injuries of Undetermined Intent 


426 


21.4 


116 


11.5 


310 


31.7 




Cancer 


413 


20.8 


228 


22.5 


185 


18.9 




Unintentional Injuries 


289 


14.5 


64 


6.3 


225 


23.0 




Heart Disease 


268 


13.5 


79 


7.8 


189 


19.3 


45 - 64 years 


TOTAL 


8,476 


597.0 


3,364 


457.6 


5,112 


746.7 




Cancer 


3,171 


223.3 


1,557 


211.8 


1,614 


235.8 




Heart Disease 


1,802 


126.9 


516 


70.2 


1,286 


187.9 




Chronic Lower Respiratory 
















Disease 4 


290 


20.4 


151 


20.5 


139 


20.3 




Diabetes 


248 


17.5 


82 


11.2 


166 


24.2 


65 + years 5 


TOTAL 


44,211 


5,139.8 


25,461 


4,909.3 


18,750 5,489.9 




Heart Disease 


12,527 


1,456.4 


7,130 


1,374.8 


5,397 


1,580.2 




Cancer 


9,885 


1,149.2 


4,998 


963.7 


4,887 


1,430.9 




Stroke 


3,114 


362.0 


2,040 


393.3 


1,074 


314.5 




Chronic Lower Respiratory 
















Disease 4 


2,435 


283.1 


1,386 


267.2 


1,049 


307.1 


1. Ranking based on number of deaths for all persons. 2 Cause of Death classified using ICD-10. See Section Definitionsx for ICD-10 codes. 3. Number of deaths 


per 100.000 residents in each age group. 4 The title of this cause of death has changed between ICD-10 and ICD-9. Chronic Lower Respiratory Disease (ICD-10 


title) corresponds to Chronic Obstructive Pulmonary Disease (COPD) (ICD-9 title). 5. See Table C-4B for leading causes of death for detailed age groups for 


persons ages 65+ years 


6 Calculations based on fewer than five events are excluded. 













99 



Table C-4B. Leading Causes of Death, Numbers and Age-Specific Rates (Ages 65 and older) by 

Gender, Massachusetts: 2003 



Total Female Male 



Age 


Cause of death 1 


Number 


Rate 2 


Number 


Rate 2 


Number 


Rate 2 


65-74 years 


TOTAL 


8,611 


2,012.7 


3,827 


1,611.2 


4,784 


2,514.0 




Cancer 


3,256 


761.0 


1.480 


623.1 


1,776 


933.3 




Heart Disease 


2,009 


469.6 


794 


334.3 


1,215 


638.5 




Chronic Lower 
















Respiratory Disease 3 


566 


132.3 


293 


123.4 


273 


143.5 




Stroke 


372 


87.0 


175 


73.7 


197 


103.5 


75-84 years 


TOTAL 


16,973 


5,377.3 


8,859 


4,535.0 


8,114 


6,745.2 




Heart Disease 


4,537 


1,437.4 


2.233 


1,143.1 


2,304 


1,915.3 




Cancer 


4,370 


1.384.5 


2,201 


1,126.7 


2,169 


1,803.1 




Stroke 


1,174 


371.9 


695 


355.8 


1,174 


371.9 




Chronic Lower 












Respiratory Disease 3 


1,084 


343.4 


601 


307.7 


483 


401.5 


85+ years 


TOTAL 


18,627 


15,962.5 


12,775 


14,899.0 


5,852 


18,909.1 




Heart Disease 


5,981 


5,125.5 


4.103 


4,785.2 


1,878 


6,068.2 




Cancer 


2,259 


1,935.9 


1.317 


1,536.0 


942 


3,043.8 




Stroke 


1,568 


1,343.7 


1,170 


1.364.5 


398 


1,286.0 




Influenza and 


1,169 


1,001.8 


779 


908.5 


390 


1,260.2 



Pneumonia 



1. Cause of Death classified according to ICO-10. See Section Definitions for ICD-10 codes. 2. Number of deaths per 100,000 residents in each age group. 3. The title 
of this cause of death has changed between ICD-10 and ICD-9. Chronic Lower Respiratory Disease (ICD-10 title) corresponds to Chronic Obstructive Pulmonary 
Disease (COPD) (ICD-9 title). 



100 



Figure C-3 



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107 



Table C-8. Number and Age-Adjusted Rates of Cancer Deaths by 
Selected Causes and Gender, Massachusetts: 2003 



Cause of Death 1 ICD-10 Total Female Male 

Code 







# 


Rate 23 


# 


Rate 


# 


Rate 


Total Cancer Deaths 


C00-C97 


13,524 


199.6 


6,803 


170.2 


6,721 


249.7 


Bladder 


C67 


355 


5.1 


114 


2.7 


241 


9.4 


Brain and nervous system 


C70-C72 


292 


4.4 


144 


3.9 


148 


5.0 


Cervix 


C53 


47 


1.3 


47 


1.3 


NA 


NA 


Colorectal 


C18-C21 


1,335 


19.5 


677 


16.2 


658 


24.8 


Esophagus 


C15 


409 


6.1 


88 


2.1 


321 


11.7 


Female breast 


C50 4 


996 


25.4 


996 


25.4 


NA 


NA 


Hodgkin's disease 


C81 


32 


0.5 


14 


0.3 


18 


0.6 


Kidney and other urinary 
organs 


C64, C65 


262 


3.9 


93 


2.3 


169 


6.2 


Leukemia 


C91-C95 


506 


• 7.4 


238 


5.8 


268 


10.0 


Lung 


C33, C34 


3,749 


55.9 


1,818 


46.5 


1,931 


69.9 


Melanoma of the skin 


C43 


214 


3.2 


80 


2.1 


134 


4.8 


Multiple myeloma 


C88, C90 


276 


4.0 


142 


3.4 


134 


5.0 


Non-Hodgkin's lymphoma 


C82-C85 


524 


7.6 


258 


6.2 


266 


10.0 


Ovary 


C56 


347 


9.1 


347 


9.1 


NA 


NA 


Pancreas 


C25 


804 


11.9 


399 


9.9 


405 


14.8 


Prostate 


C61 


706 


29.1 


NA 


NA 


706 


29.1 


Stomach 


C16 


299 


4.4 


134 


3.1 


165 


6.1 


Uterus 


C54, C55 


177 


4.5 


177 


4.5 


NA 


NA 


All other cancers 


Residual 


2,194 


32.4 


1,036 


25.3 


1,157 


42.2 



1. Common terms are used to describe the causes of cancer deaths. For detailed terminology of cancer sites, please refer to ICD-10 code list in the 
Section Definitions. 2. All rates are age-adjusted by the direct method using the 2000 US standard population. Rates are per 100,000 population. 3. 
The total resident population is used to calculate all "Total Rates" except for ICD-10 C50, C53-C56, which are based on the total female population, and 
ICD-10 C61 , which is based on the total male population. 4. Includes only female breast cancer. 



108 



Table C-9. Selected Causes of Cancer Deaths by Age, Massachusetts: 2003 





Can^p of HpAth^ 


ICD-10 Code 


Numhpr 

MUM IUCI 




1-14 years 


TOTAL 




23 


1.9 




Brain and nervous system 




5 


0.4 




ueuKemia 


C91-C95 


A 
1 


3 




Colorectal 


C18-C21 


1 


_3 




Kidney and other urinary organs 


C64, C65 


1 


3 


15-24 years 


TOTAL 




29 


3.5 




Leukemia 


C91-C95 


8 


1.0 




Drain diiu nervous oyoicrn 




4 


_3 




Non-Hodgkin's lymphoma 


C82-C85 


4 


3 




Hodgkin's disease 


C81 


2 


3 


25-44 years 


TOTAL 




413 


20.8 




Lung 


CoJ, OJ4 


76 


3.8 




Pamela h\ro^ct^ 
Pel 1 Idle Ulcdbi 


C50 


CO 
DO 


P. 9 




Brain and nervous system 


C70-C72 


35 


1.8 




Leukemia 


C91-C95 


30 


1.5 


45-64 years 


TOTAL 




3,171 


223.3 




Lung 


C33, C34 


956 


67.3 




remaie ureasi 






AO A 

4*1.4 




Colorectal 


C18-C21 


274 


19.3 




Pancreas 


C25 


198 


13.9 




1 \J 1 ML 






1 149 2 




1 nnn 
i_ui ly 


C33 C34 


9 717 

£,l If 


O 1 O. 




Colorectal 


C18-C21 


1,030 


119.7 




Prostate 5 


C61 


655 


191.8 




Female breast 4 


C50 


621 


119.7 


65 — 74 years 


TOTAL 




1 ICC 
J, ZOO 


7R1 n 
/ I .u 




Lung 


poo r"3/i 
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4 4 on 

1,130 


OCyl -1 

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Colorprtal 


C18-C21 




65.9 




Pancreas 


C25 


208 


48.6 




Female breast 4 


C50 


167 


70.3 


75 - 84 years 


TOTAL 




jl 07H 

4,370 


A 0< C 

1 ,oo4.t> 




Lung 


POO /^Oyl 

CJ3, Co4 


1,195 


378.6 




(™*nlnrprtal 


C18-C21 




142.9 




Prostate 5 


C61 


307 


255.2 




Pancreas 


C25 


263 


83.3 


85+ years 


TOTAL 




2,259 


1,935.9 




Lung 


C33, C34 


392 


335.9 




Colorectal 


C18-C21 


297 


254.5 




Prostate 5 


C61 


250 


807.8 




Female breast 4 


C50 


213 


248.4 



1. Common terms are used to describe causes of cancer death For detailed terminology, please refer to the ICD-10 codes listed in the Section 
Definitions. 2. Number of deaths per 100,000 residents in each age group. 3. Calculations based on fewer than five events are excluded. 4. 
Calculation based on female population in specified age group. 5. Calculation based on male population in specified age group. 



109 



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112 



Table C-11B. Intentional Injury Deaths 1 by 
Gender, Age, Race and Hispanic Ethnicity: Numbers, 
Age-Adjusted, and Age-Specific Rates, Massachusetts: 2003 





All Intentional 


Suicide 




Homicide 




! Number 


n . 2 

Rate 


Number 


r\dlo 


Number 


n i 2 

Rate 


All Persons 


562 


8.7 


423 


6.5 


139 


2.2 


<1 


4 


3 


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3 


4 


A 


1-14 


13 


1.1 


i 5 


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8 


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11.3 


; 46 


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47 


5.7 


25-44 


; 229 


11.5 


177 


8.9 


52 


2.6 


45-64 


154 


10.8 


135 


9.5 


19 


1.3 


65-74 


32 


7.5 


28 


6.5 


4 


3 


75-84 


23 


7.3 


20 


6.3 


3 


3 


85+ 


14 


12 


12 


10.3 


2 


_3 


All Females 


129 


3.8 


104 


3.1 


25 


0.7 


<1 


2 


3 





3 


2 


3 


1-14 


3 


3 


2 


3 


1 


3 


15-24 


8 


1.9 


5 


1.2 


3 


3 


25-44 


52 


5.1 


43 


4.3 


9 


0.9 


45-64 


46 


6.3 


40 


5.4 


6 


A O 

U.o 


65-74 


7 


2.9 


6 


2.5 


1 


_3 


75-84 


9 


4.6 


6 


3.1 


3 


3 


85+ 


2 


6 


2 


_3 





3 


All Males 


433 


14.2 


319 


10.4 


114 


3.7 


<1 : 


2 


3 





3 


2 


6 


1-14 : 


10 


1.7 


3 


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7 


1.2 


15-24 


85 


20.8 | 


41 


10 


44 


10.8 


25-44 j 


177 


18.1 


134 


13.7 


43 


4.4 


45-64 : 


108 


15.8 : 


95 


13.9 


13 


1.9 


65-74 ; 


25 


13.1 i 


22 


11.6 


3 


3 ■ 


75-84 ■ 


14 


11.6 ; 


14 


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3 


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12 


38.8 : 


10 


32.3 


2 


3 



I. Data presented in this table are classified according to ICD-10. Please refer to Section Definitions for a list of ICD-10 codes used in this table. 2. Number of 
deaths per 100,000 persons in each age group; rates for all rows except the age group rows are age-adjusted to the 2000 US standard population. 
3. Calculations based on fewer than five events are excluded. 



113 



Table C-11B (continued). Intentional Injury Deaths 1 by 
Gender, Age, Race and Hispanic Ethnicity: Numbers, 
Age-Adjusted, and Age-Specific Rates, Massachusetts: 2003 





All Intentional 


Suicide 




Homicide 




Number 


Rate 2 


Mi imhpr 


Rate 2 


Number 


Rate 2 


White non- Hispanic 


417 


7.5 


371 


6.7 


46 


0.9 


Females 


105 


3.6 


93 


3.2 


12 


0.4 


Males 


312 


12.0 


278 


10.6 


34 


1.4 


Black non- Hispanic 


66 


17.8 


20 


5.7 


46 


12.2 


Females 


6 


3.9 


1 


_3 


5 


3.0 


Males 


60 


32.3 


19 


10.8 


41 


21.5 


Asian non- Hispanic 


22 


10.7 


14 


7.4 


8 


3.3 


Females 


10 


10.6 


7 


8.0 


3 


__3 


Males 


12 


10.5 


7 


6.3 


5 


4.2 


Hispanic 


54 


12.6 


16 


3.9 


38 


8.6 


Females 


7 


3.5 


2 




5 


2.8 


Males 


47 


22.3 


14 


7.5 


33 


14.9 



1. Data presented in this table are classified according to ICD-10. Please refer to Section Definitions for list of ICD-10 codes used in this table. 2. Number of 
deaths per 100,000 persons in each age group; rates for all rows except the age group rows are age-adjusted to the 2000 US standard population. 3. 
Calculations based on fewer than five events are excluded. 



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116 



Table C-11E. Poisoning Deaths 1 of Undetermined Intent 
by Agent, Massachusetts: 2003 



Poisoninq Aqent 


Number 


Percent 


Narcotics and hallucinogens 3 


607 


90.1 


Other and unspecified drugs, medicaments, 
bioloqical substances 


32 


4.8 


Antiepileptic, sedative-hypnotic, antiparkinsonism & 
psychotropic 


21 


3.1 


Gases and vapors 


4 


__2 


Alcohol 


2 


2 


Nonopioid analgesics, antipyretics & 
antirheumatics 


2 


__2 


Other and unspecified chemicals and noxious 
substances 


2 


__2 


Other drugs acting on autonomic nervous system 


2 


__2 


Organic solvents and halogenated hydrocarbons 
and their vapors 


1 


__2 


Pesticides : 


1 


__2 


TOTAL 


674 


100% 



1 Data presented in this table are classified according to ICD-10. Please refer to Section Definitions for a list of ICD- 
10 codes used in this table. 

2. Calculations based on fewer than five events are excluded. 

3. Includes: cannabis, cocaine, codeine, heroin, lysergide (LSD), mescaline, methadone, morphine, and opium 
(alkaloids). 



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Table C-12D. HIV/AIDS 1 Deaths by Gender, Race and Hispanic Ethnicity: 
Numbers, Percent and Age-adjusted Rates, Massachusetts: 1999-2003 



TOTAL White non-Hispanic 2 Black non-Hispanic 2 Hispanic 



Year 


# 


Percent 


Rate 3 


# 


Percent 


Rate 3 


# 


Percent 


Rate 3 


1999 


126 


52% 


2.3 


51 


21% 


17.0 


63 


27% 


20.2 


2000 


104 


46% 


1.9 


61 


27% 


19.5 


59 


26% 


17.7 


2001 


125 


50% 


2.2 


73 


29% 


23.4 


51 


20% 


14.7 


2002 


108 


47% 


1.9 


68 


30% 


23.1 


52 


23% 


15.4 


2003 


113 


50% 


2.1 


58 


26% 


17.2 


53 


23% 


12.4 


MALE 


1999 


97 


55% 


3.6 


33 


19% 


23.5 


45 


25% 


31.3 


2000 


77 


48% 


2.8 


40 


25% 


27.7 


42 


26% 


28.1 


2001 


92 


51% 


3.4 


50 


27% 


34.8 


40 


22% 


24.5 


2002 


86 


53% 


3.1 


43 


26% 


31.7 


34 


21% 


21.4 


2003 


74 


49% 


2.9 


.36 


24% 


22.2 


39 


26% 


18.4 


FEMALE 


1999 


29 


45% 


1.0 


18 


28% 


11.0 


18 


28% 


10.4 


2000 


27 


42% 


1.0 


21 


32% 


12.3 


17 


26% 


8.7 


2001 


33 


49% 


1.2 


23 


34% 


13.5 


11 


16% 


5.8 


2002 


22 


33% 


0.8 


25 


38% 


15.6 


18 


27% 


9.9 


2003 


39 


51% 


1.4 


22 


29% 


12.6 


14 


18% 


6.5 



1. AIDS and HIV disease deaths coded using ICD-10: B20-B24. 2. Race and ethnicity data in this table are presented as mutually exclusive categories. Persons of 
Hispanic ethnicity are not included in a race category. 3. Number of deaths per 100,000 persons; rates are age-adjusted to the 2000 US standard population. 



121 



Table C-13. HIV/AIDS 1 Deaths by Race, Hispanic Ethnicity, and Gender: 
Persons Ages 25-44, Massachusetts: 1993 - 2003 



White non-Hispanic 2 Black non-Hispanic 2 Hispanic 

TOTAL 



Year 


# 


Rate 3 


# 


Rate 


# 


Rate 


# 


Rate 


# 


Rate 


# 


Rate 




Comparability 




Comparability 


Comparability 




Comparability 


Comparability 


Comparability 




Unmodified 




Modified 4 


Unmodified 




Modified 4 


Unmodified 


Modified 4 


1993 


391 


22.3 




NA 5 


NA 5 


122 


130.4 




NA 5 


NA 5 


76 


73.0 


NA 5 


NA 5 


1994 


451 


25.6 




480 


27.2 


152 


162.0 




162 


172.3 


127 


118.3 


135 


125.8 


1995 


428 


24.3 




455 


25.8 


159 


169.7 




169 


180.5 


124 


113.0 


132 


120.2 


1996 


251 


14.2 




267 


15.1 


113 


121.1 




120 


128.8 


85 


75.4 


90 


80.2 


1997 


86 


4.9 




98 


5.6 


48 


51.3 




55 


58.7 


36 


31.1 


41 


35.6 


1998 


68 


3.9 




78 


4.5 


38 


40.7 




44 


46.6 


47 


39.8 


54 


45.6 


1999 






74 6 


4.4 








32 6 


31.2 






40 6 


30.5 




2000 






fif) 6 

yj\j 


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L-O 


25.3 






40 6 


27.9 




2001 






70 6 


4.3 








35 6 


31 .6 






31 


04 "7 

21 .7 




2002 






42 6 


2.6 








24 6 


21.7 






35 6 


24.4 




2003 






63 6 


3.8 








19 6 


17.2 






25 6 


17.5 




MALE 






























iyyo 


350 


40.3 




NA 5 


NA 5 


91 


197.6 




NA 5 


NA 5 


57 


110.3 


NA 5 


NA 5 


1QQ4 


388 


44.5 




413 


47.3 


113 


244.3 




120 


259.9 


93 


174.2 


99 


185.3 


a one 

iyyo 


367 


42.1 




390 


44.8 


112 


242.2 




119 


257.6 


90 


164.5 


96 


175.0 


1996 


221 


25.3 




235 


26.9 


73 


158.1 




78 


168.2 


61 


108.5 


65 


115.4 


1997 


71 


8.1 




81 


9.3 


30 


64.6 




34 


74.0 


28 


48.5 


32 


55.5 


1998 


57 


6.6 




65 


7.6 


27 


58.2 




31 


66.6 


34 


57.7 


39 


66.1 


1999 






RA 6 


6.5 








9f> 6 


39.9 






30 6 


46.2 




2000 






39 6 


A Q 

4.0 








17 6 


oi .y 






07 6 
£.1 


Oft A 




2001 






46 6 


5.7 








19 6 


35.6 






23 6 


32.7 










29 


3.6 








15 


28.1 






21 6 


29.9 




2003 






42 


5.2 








10 


18.8 






19 6 


27.0 




FEMALE 






























1993 


41 


4.6 




NA 


NA 


31 


65.2 




NA 


NA 


19 


36.3 


NA 


NA 


1994 


63 


7.1 




67 


7.6 


39 


82.0 




41 


87.2 


34 


63.0 


36 


67.0 


1995 


61 


6.9 




65 


7.3 


47 


99.0 




50 


105.3 


34 


61.8 


36 


65.7 


1996 


30 


3.4 




32 


3.6 


40 


84.9 




43 


90.3 


24 


42.4 


26 


45.1 


1997 


15 


1.7 




17 


1.9 


18 


38.2 




21 


43.7 


8 


13.8 


9 


15.8 


1998 


11 


1.3 




13 


1.5 


11 


23.4 




13 


26.8 


13 


22.0 


15 


25.2 


1999 






20 6 


2.3 








12 6 


22.9 






10 6 


15.1 




2000 






21 6 


2.5 








11 6 


19.2 






13 6 


17.8 




2001 






24 6 


2.9 








16 6 


27.9 






8 6 


11.0 




2002 






13 6 


1.6 








9 6 


15.7 






14 6 


19.2 




2003 






21 6 


2.5 








9 6 


15.7 






6 6 


8.2 





1. AIDS and HIV disease deaths for years 1989-1998 coded using ICD-9: 042-044; 1999-2003 deaths coded using ICD-10: B20-B24. 2. Race and ethnicity data in 
this table are presented as mutually exclusive categories Persons of Hispanic ethnicity are not included in a race category. 3. Number of deaths per 100,000 
residents in the specified population group. 4. Comparability Modified (CM) number and rate based on preliminary comparability ratios (CR) from NCHS (June 
2001). CM data for 1994-1996 use 1996 based CR; CM data for 1997-1998 use revised 1998 based CR. 5. NA = not applicable. 6. When comparing data over 
time between 1994 through 2003, please use comparability modified data for years 1994-1998. 



122 



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126 





Table C-14B. 


Medical Examiner Certified Deaths by County, 








Massachusetts Occurrence: 


2003 
















Keterred- 


Natural Cause 








Occurrence 


M.E. 


Not Certified 


ueains oeniiieo 


County 




Population 


Deaths 


Certified 


by M.E. 


By M.E. 


Total 


# 


6,442,506 


56,916 


3,995 


10,654 


1,509 




% 


100.00% 


100.00% 


7.02% 


18.72% 


37.77% 


Barnstable 


# 


228,963 


2,705 


172 


410 


73 




% 


3.55% 


4.64% 


6.36% 


15.16% 


42.44% 




Rank 


9 


9 


10 


12 


6 


Berkshire 


# 


133,094 


1,587 


90 


300 


31 




% 


2.07% 


2.72% 


5.67% 


18.90% 


34.44% 




Rank 


11 


10 


13 


5 


12 


Bristol 


# 


547,615 


4,844 


408 


839 


172 




% 


8.50% 


8.32% 


8.42% 


17.32% 


42.16% 




Rank 


6 


7 


4 


9 


7 


Dukes 


# 


15,569 


125 


21 


17 


15 




% 


0.24% 


0.21% 


16.80% 


13.60% 


71.43% 




Rank 


13 


13 


1 


13 


1 


Essex 


# 


745,548 


6,280 


401 


1,017 


148 




% 


11.57% 


10.79% 


6.39% 


16.19% 


36.91% 




Rank 


3 


4 


9 


11 


9 


Franklin 


# 


72,054 


478 


33 


85 


16 




% 


1.12% 


0.84% 


6.90% 


17.78% 


48.48% 




Rank 


12 


12 


7 


8 


2 


Hampden 


# 


464,651 


5,011 


376 


994 


136 




% 


7.21% 


8.61% 


7.50% 


19.84% 


36.17% 




Rank 


8 


6 


5 


3 


10 


Hampshire 


# 


154,155 


980 


54 


181 


19 




% 


2.39% 


1.68% 


5.51% 


18.47% 


35.19% 




Rank 


10 


11 


14 


6 


11 


Middlesex 


# 


1,469,286 


10,643 


606 


2,025 


244 




% 


22.81% 


18.28% 


5.69% 


19.03% 


40.26% 




Rank 


1 


1 


12 


4 


8 


Nantucket 


# 


9,944 


60 


9 


4 


4 




% 


0.15% 


0.10% 


15.00% 


6.67% 


44.44% 




Rank 


14 


14 


2 


14 


4 


Norfolk 


# 


655,350 


5,170 


299 


881 


140 




% 


10.17% 


8.89% 


5.78% 


17.04% 


46.82% 




Rank 


5 


5 


11 


10 


3 


Plymouth 


# 


491,440 


3,695 


269 


660 


116 




% 


7.63% 


6.35% 


7.28% 


17.86% 


43.12% 




Rank 


7 


8 


6 


7 


5 


Suffolk 


# 


676,348 


8,324 


778 


1,843 


237 




% 


10.50% 


14.30% 


9.35% 


22.14% 


30.46% 




Rank 


4 


2 


3 


1 


14 


Worcester 


# 


778,488 


7,014 


479 


1,398 


158 




% 


12.08% 


12.06% 


6.83% 


19.93% 


32.99% 




Rank 


2 


3 


8 


2 


13 



The percentages and ranks in the Medical Examiner Certified Deaths column and the Referred column are based on 
totals in the Occurrence Deaths column. The percentages and ranks of natural cause of death are based on total 
number of medical examiner certified deaths for each county. Total population based on sum of county estimates. 



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158 



INFANT & NEONATAL DEATHS 



SECTION D 



INFANT AND NEONATAL DEATHS 

The total number of resident infant deaths (deaths of children less than 1 year of age) 
decreased by 3.5% in Massachusetts from 397 in 2002 to 383 in 2003. The rate of infant 
deaths also decreased from 4.9 infant deaths per 1,000 live births in 2002 to 4.8 infant 
deaths per 1,000 live births in 2003. As with live births and other deaths, all Massachusetts 
resident infant deaths are included regardless of the state in which they occurred. 
Neonatal deaths (deaths of infants under 28 days of age) decreased from 299 in 2002 to 285 
in 2003, a decrease of 4.7%. The rate of neonatal deaths also decreased, from 3.7 in 2002 to 
3.6 in 2003. 



INFANT DEATHS BY RACE 

Beginning with the publication of 1989 data, several changes occurred in the method of 
calculating infant mortality rates (IMRs) by race and ethnicity. These changes affect only 
the calculation of race/ethnic infant mortality rates; all other data presented in this 
publication are comparable to information from previous years. These changes are the 
result of new federal recommendations for analyzing birth information, including infant 
mortality data, and the implementation of the new Massachusetts Standard Certificate of 
Death in 1989. 

Infants born to Black non-Hispanic mothers continue to have the highest infant mortality 
rates. The IMR for Black non-Hispanics in 2003 was 12.7 per 1,000 live births. This 
represents an increase of 1.1 (9.5%) from the 2002 rate, and it is over triple the IMR for 
White non-Hispanic infants. 

In 2003, the IMR for Hispanics decreased to 5.6 per 1,000 live births from 7.0 per 1,000 live 
births in 2002. This change is a 20% decline. The mortality experience of infants born to 
Hispanic mothers is more similar to the experience of infants born to White non-Hispanic 
mothers than to Black non-Hispanic mothers. The 2003 IMR of 5.6 for Hispanic infants is 
36.6% higher than the White non-Hispanic rate and 55.9% below the Black non-Hispanic 
rate. 

Asian mothers had the lowest rates of infant mortality compared to the other race/ethnicity 
groups. This is consistent with prior years with the exception of 1995 and 2000, when the 
rate rose above that of White non-Hispanics. In 2003, the Asian IMR was 2.7 deaths per 
1,000 live births. However, caution should be used when interpreting this rate since it is 
based on a small number (14) of deaths. 



INFANT DEATHS BY CAUSE 

"Certain conditions originating in the perinatal period" (medical conditions arising from 
approximately 28 weeks gestation to 28 days of age) was the leading cause of death for 
White, Black, Asian and Hispanic infants. Congenital anomalies represented the second 
leading cause of death among White non-Hispanic, Black non-Hispanic, and Hispanic 



159 



infants; however it was tied for second with "Signs and symptoms of an ill-defined 
condition" among Black non-Hispanics. 

The overall leading causes of infant death were "Conditions arising in the perinatal period" 
(230 deaths) and "Congenital anomalies" (61 deaths), which underwent 7.6% and 6.2% 
decreases, respectively, from 2002. Other causes of infant death were: Sudden Infant 
Death Syndrome (29 deaths), "Disorders relating to short gestation and unspecified low 
birthweight" (94 deaths), "Other respiratory conditions of newborn" (10 deaths), and 
"Homicide" (4 deaths). There were 4 fewer deaths from SIDS in 2003 than there were in 
2002, representing a 12.1% decrease. The number of homicide deaths (4) has remained 
relatively constant since 1994. 

SIDS remains the leading cause of death in the post-neonatal period (28-364 days), while 
"disorders relating to short gestation and low birthweight" was the leading cause in the 
neonatal period (1-27 days). 



NEONATAL AND POST-NEONATAL MORTALITY RATES 

The neonatal mortality rate, infants less than 28 days old, was 3.6 deaths per 1,000 live 
births in 2003. Among White non-Hispanic mothers, the neonatal mortality rate decreased 
slightly (3.1%), from 3.2 in 2002 to 3.1 in 2003. During this same time period, the rate 
increased by 8.5% among Black non-Hispanic mothers (from 8.2 in 2002 to 9.5 in 2003) and 
decreased by 25% among Hispanic mothers (from 5.2 in 2002 to 3.9 in 2003). Among 
Asians, the number of neonatal deaths decreased from 13 to 10 in between 2002 and 2003, 
with the rates falling from 2.4 to 1.9. These rates should be interpreted cautiously since 
they are based on very few deaths. 

The overall post-neonatal mortality rate, representing the number of deaths of infants 
between 28 and 364 days of age per 1,000 live births, was roughly equivalent in 2003 and 

2002, at 1.2. The post-neonatal mortality rate among infants of White non-Hispanic mothers 
rose in 2003 9.1% from 1.2 deaths per 1,000 live births from 1.1 in 2002. Among infants of 
Black, non-Hispanic mothers, the post neonatal mortality rate decreased between 2002 and 

2003, from 3.4 to 3.2 deaths per 1,000 births; a 5.9% decrease. 

There was a small decrease in the rate of post-neonatal deaths among Hispanics, from 1.8 
to 1.7, corresponding to a rate decrease of 5.6%. The number of post-neonatal deaths 
among Asians rose from 3 in 2002 to 4 in 2003. 

DEFINITIONS IMPORTANT FOR THIS SECTION INCLUDE : 

INFANT DEATH 

Death of a child whose age is less than one year (365 days). 
NEONATAL DEATH 

Death of a child whose age is less than 28 days. 



160 



POST-NEONATAL DEATH 

Death of a child whose age is at least 28 days, but less than one year. 



RATES IMPORTANT FOR THIS SECTION INCLUDE : 

INFANT # of Resident Deaths at Less than 1 Year of Age x 1 ,000 

MORTALITY RATE Total Resident Live Births 

(IMR) 

NEONATAL # of Resident Deaths at Less than 28 Days of Age x 1 ,000 

MORTALITY RATE Total Resident Live Births 

(NMR) 

POST-NEONATAL # of Resident Deaths at Least 28 Days of Age but <365 Days of Age x 1 ,000 

MORTALITY RATE Total Resident Live Births 

(PNMR) 



161 




162 




163 



Table D-1. Trends in Infant, Neonatal, and Post-Neonatal Mortality, by Race and Hispanic 

Ethnicity, Massachusetts: 1990-2003 



INFANT MORTALITY (less than one year of age) 





State Total 1 


White non- 
Hispanic 


Black non- 
Hispanic 


Hispanic 


Asian 




Other 2 


Year 


n 


Kate 


n 


Kate 


n 


Kate 


n 


Kate 


n 


Kate 


n 


Rate 


1990 


649 


7.0 


442 


6.1 


98 


13.7 


77 


9.1 


24 


7.0 


8 


9.5 


1991 


C77 

Oil 


D.O 


ool 


0.0 


101 


lo.O 


80 


C\ A 

9.4 


A A 

14 


A O 

4.2 


1 


4 


1992 


569 


6.5 


371 


5.5 


110 


16.4 


67 


7.9 


16 


4.9 


5 


5.1 


1993 


523 


6.2 


346 


5.3 


84 


13.1 


77 


9.3 


13 


3.9 


3 


4 


1994 


499 


6.0 


343 


5.3 


79 


12.6 


64 


7.6 


8 


2.4 


5 


5.3 


1995 


419 


5.1 


275 


4.4 


65 


11.1 


58 


7.2 


19 


5.5 


2 


4 


1996 


403 


5.0 


289 


4.7 


63 


11.4 


40 


5.1 


8 


2.2 


2 


4 


1997 


425 


5.3 


294 


4.8 


64 


11.7 


55 


6.7 


10 


2.6 


2 


4 


1998 


414 


5.1 


287 


4.6 


59 


10.6 


58 


6.7 


10 


2.7 





0.0 


1999 


418 


5.2 


285 


4.7 


72 


12.3 


49 


5.5 


8 


1.9 


4 


4 


2000 


377 


4.6 


232 


3.8 


74 


12.8 


48 


5.2 


19 


4.1 


4 


4 


2001 


407 


5.0 


245 


4.1 


71 


12.1 


69 


7.3 


15 


3.1 


7 


4.1 


2002 


397 


4.9 


239 


4.1 


69 


11.6 


67 


7.0 


16 


3.0 


6 


3.8 


2003 


383 


4.8 


235 


4.1 


75 


12.7 


55 


5.6 


14 


2.7 


4 


4 


NEONATAL MORTALITY (birth to 27 days) 




State Total 1 


White non- 
Hispanic 


Black non- 
Hispanic 


Hispanic 


Asian 


Other 2 


Year 


n 


Rate 3 


n 


Rate 3 


n 


Rate 3 


n 


Rate 3 


n 


Rate 3 


n 


Rate 3 


1990 


446 


4.8 


298 


4.1 


75 


10.5 


49 


5.8 


19 


5.5 


5 


5.5 


1991 


401 


4.5 


266 


3.9 


72 


10.7 


53 


6.2 


10 


3.0 





0.0 


1992 


415 


4.8 


274 


4.0 


76 


11.4 


51 


6.0 


10 


3.0 


4 


4 


1993 


375 


4.4 


245 


3.7 


64 


10.0 


55 


6.7 


9 


2.7 


2 


4 


1994 


349 


4.2 


240 


3.7 


58 


9.3 


40 


4.7 


7 


2.1 


4 


4 


1995 


298 


3.6 


198 


3.1 


50 


8.5 


39 


4.8 


10 


2.9 ' 


1 


4 


1996 


290 


3.6 


222 


3.6 


34 


6.2 


27 


3.5 


5 


1.4 


1 


4 


1997 


323 


4.0 


228 


3.7 


44 


8.0 


43 


5.2 


7 


1.8 


1 


4 


1998 


315 


3.9 


218 


3.5 


47 


8.5 


43 


5.0 


7 


1.9 





0.0 


1999 


332 


4.1 


226 


3.7 


58 


9.9 


39 


4.4 


5 


1.2 


4 


4 


2000 


288 


3.5 


177 


2.9 


57 


9.9 


37 


4.0 


14 


3.0 


3 


4 


2001 


308 


3.8 


190 


3.2 


56 


9.5 


49 


5.2 


10 


2.1 


3 


4 


2002 


299 


3.7 


185 


3.2 


49 


8.2 


50 


5.2 


13 


2.4 


2 


4 


2003 


285 


3.6 


179 


3.1 


56 


9.5 


38 


3.9 


10 


1.9 


2 


4 



1 . Deaths of infants of unknown race are included in the total calculation. For rate computations, births of infants of unknown race are allocated into 
the race categories according to the distribution of births of known race. 2. Other: American Indian and Other races. 3. Rates are expressed per 1 ,000 
live births. 

4. Calculations based on fewer than five events are excluded. 



164 



Table D-1 (continued). Trends in Infant, Neonatal, and Post-Neonatal Mortality, by Race and 

Hispanic Ethnicity, Massachusetts: 1990-2003 



POST-NEONATAL MORTALITY (28-364 days) 



State Total 1 



White non- 
Hispanic 



Black non- 
Hispanic 



Hispanic 



Asian 



Other 2 



Year 


n 


Rate 3 


n 


Rate 3 


n 


Rate 3 


n 


Rate 3 


n 


Rate 3 


n 


Rate 


1990 


203 


2.2 


144 


2.0 


23 


3.2 


28 


3.3 


5 


1.5 


3 


4 


1991 


176 


2.0 


115 


1.7 


29 


4.3 


27 


3.2 


4 


4 




4 


1992 


154 


1.8 


97 


1.4 


34 


5.1 


16 


1.9 


6 


1.8 


1 


4 


1993 


148 


1.7 


101 


1.5 


20 


3.1 


22 


2.7 


4 


4 




4 


1994 


150 


1.8 


103 


1.6 


21 


3.3 


24 


2.8 


1 


4 




__4 


1995 


121 


1.5 


77 


1.2 


15 


2.6 


19 


2.3 


9 


2.6 




4 


1996 


113 


1.4 


67 


1.1 


29 


5.3 


13 


1.7 


3 


4 




4 


1997 


102 


1.3 


66 


1.1 


20 


3.7 


12 


1.5 


3 


_ 4 




4 


1998 


99 


1.2 


69 


1.1 


12 


2.2 


15 


1.7 


3 


4 





0.0 


1999 


86 


1.1 


59 


1.0 


14 


2.4 


10 


1.1 


3 


4 





0.0 


2000 


89 


1.1 


55 


0.9 


17 


2.9 


11 


1.2 


5 


1.1 


1 


4 


2001 


99 


1.2 


55 


0.9 


15 


2.6 


20 


2.1 


5 


1.0 


4 


4 


2002 


98 


1.2 


54 


0.9 


20 


3.4 


17 


1.8 


3 


4 


4 


4 


2003 


98 


1.2 


56 


1.0 


19 


3.2 


17 


1.7 


4 


4 


2 


4 



1 . Deaths of infants of unknown race are induded in the total calculation. For rate computations, births of infants of unknown race are allocated into the race 
categories according to the distribution of births of known race 2. Other. American Indian and Other races. 3. Rates are expressed per 1 ,000 live births. 
4. Calculations based on fewer than five events are excluded. 



Table D-2. Trends in Infant, Neonatal, and Post-Neonatal Mortality by 
Race 1 , Massachusetts: 1980-2003 

INFANT MORTALITY (less than one year of age) 



State Total 2 White Black Asian/Other 3 



Year 


n 


Rate 4 


n 


Rate 4 


n 


Rate 4 


n 


Rate 


1980 


748 


10.3 


655 


9.8 


87 


18.6 


5 


4.6 


1981 


710 


9.6 


616 


9.1 


85 


18.2 


8 


6.1 


1982 


764 


10.1 


656 


9.4 


102 


21.3 


5 


3.3 


1983 


682 


9.0 


579 


8.3 


89 


19.0 


12 


7.4 


1984 


699 


8.9 


601 


8.4 


82 


16.4 


13 


7.5 


1985 


745 


9.1 


608 


8.1 


126 


23.8 


11 


6.1 


1986 


695 


8.4 


560 


7.5 


123 


22.0 


11 


4.6 


1987 


608 


7.2 


486 


6.4 


110 


17.5 


12 


4.5 


1988 


693 


7.9 


546 


7.0 


133 


19.5 


13 


3.8 


1989 


697 


7.6 


549 


6.8 


131 


17.7 


17 


4.8 


1990 


649 


7.0 


519 


6.4 


106 


13.7 


24 


6.5 


1991 


577 


6.5 


461 


6.0 


102 


13.8 


14 


3.9 


1992 


569 


6.5 


438 


5.7 


114 


15.8 


17 


4.7 


1993 


523 


6.2 


423 


5.7 


87 


12.5 


13 


3.5 


1994 


499 


6.0 


407 


5.6 


81 


12.0 


11 


2.9 


1995 


419 


5.1 


333 


4.7 


65 


10.3 


21 


5.5 


1996 


403 


5.0 


329 


4.7 


65 


10.8 


8 


2.0 


1997 


425 


5.3 


349 


5.0 


66 


10.6 


10 


2.4 


1998 


414 


5.1 


345 


4.9 


59 


9.3 


10 


2.3 


1999 


418 


5.2 


334 


4.8 


75 


11.4 


9 


1.9 


2000 


377 


4.6 


280 


4.0 


76 


11.7 


19 


3.6 


2001 


407 


5.0 


314 


4.5 


77 


11.7 


16 


3.0 


2002 


397 


4.9 


306 


4.5 


74 


11.1 


17 


2.9 


2003 


383 


4.8 


290 


4.3 


78 


11.8 


15 


2.6 



1. Hispanic origin could not be identified from the Massachusetts death certificate before 1989; thus, Hispanic trend data are 
not available. Most Hispanics are included in the race category of White. Hispanic infant mortality data for the years 1990 
through 2003 are presented in Table D-1 . 2. Deaths of infants of unknown race are included in the total calculation. For rate 
computations, infants of unknown race are allocated into the race categories according to the distribution of births of known race. 
Other: American Indian and Other races. 4. Rates are expressed per 1,000 live births. 5. Calculations based on fewer 
than five events are excluded. 



166 



Table D-2 (continued). Trends in Infant, Neonatal, and Post-Neonatal 
Mortality by Race 1 , Massachusetts: 1980-2003 



NEONATAL MORTALITY (birth to 27 days) 



Year 


State Total 2 


White 




Black 


Asian/Other 3 


n 


Rate 4 


n 


Rate 4 


n 


Rate 4 


n 


Rate 4 


1980 


550 


7.6 


483 


7.2 


62 


13.3 


5 


4.6 


1981 


510 


6.9 


442 


6.5 


59 


12.4 


5 


3.8 


1982 


573 


7.6 


494 


7.1 


75 


15.7 


3 


__5 


1983 


482 


6.3 


411 


5.9 


63 


13.4 


7 


4.3 


1984 


472 


6.0 


411 


5.8 


49 


9.8 


8 


4.6 


1985 


538 


6.6 


447 


6.0 


85 


16.0 


5 


2.8 


1986 


478 


5.8 


383 


5.2 


89 


15.9 


5 


2.1 


1987 


432 


5.1 


343 


4.6 


80 


12.7 


9 


3.4 


1988 


477 


5.4 


383 


4.9 


87 


12.8 


6 


1.8 


1989 


479 


5.2 


376 


4.7 


95 


12.8 


8 


2.3 


1990 


446 


4.8 


347 


4.3 


80 


10.3 


9 


5.1 


1991 


401 


4.5 


319 


4.1 


72 


9.8 


10 


2.8 


1992 


415 


4.8 


325 


4.3 


79 


10.9 


11 


3.1 


1993 


375 


4.4 


300 


4.1 


66 


9.5 


9 


2.4 


1994 


349 


4.2 


280 


3.8 


60 


8.9 


9 


2.4 


1995 


298 


3.6 


237 


3.3 


50 


7.9 


11 


2.9 


1996 


290 


3.6 


249 


3.5 


35 


5.8 


5 


1.2 


1997 


323 


4.0 


271 


3.9 


45 


7.2 


7 


1.7 


1998 


315 


3.9 


261 


3.7 


47 


7.4 


7 


1.6 


1999 


332 


4.1 


265 


3.8 


61 


9.3 


6 


1.3 


2000 


288 


3.5 


214 


3.1 


58 


8.9 


14 


2.7 


2001 


308 


3.8 


239 


3.5 


59 


9.0 


10 


1.9 


2002 


299 


3.7 


235 


3.4 


51 


7.6 


13 


2.2 


2003 


285 


3.6 


217 


3.2 


58 


8.8 


10 


1.8 



1. Hispanic origin could not be identified from the Massachusetts death certificate before 1989; thus, Hispanic trend data are 
not available. Most Hispanics are included in the race category of White. Hispanic infant mortality data for the years 1990 
through 2003 are presented in Table D-1. 2. Deaths of infants of unknown race are included in the total calculation. For rate 
computations, infants of unknown race are allocated into the race categories according to the distribution of births of known race. 
Other American Indian and Other races. 4. Rates are expressed per 1,000 live births. 5. Calculations based on fewer 
than five events are excluded. 



167 



Table D-2 (continued). Trends in Infant, Neonatal, and Post-Neonatal 
Mortality by Race 1 , Massachusetts: 1980-2003 



POST-NEONATAL MORTALITY (28-364 days) 

State Total 2 White Black Asian/Other 3 



Year 


n 


Rate 4 


n 


Rate 4 


n 


Rate 4 


n 


Rate 4 


1980 


198 


2.7 


172 


2.6 


25 


5.3 





0.0 


1981 


200 


2.7 


174 


2.6 


26 


5.8 


3 


__5 


1982 


191 


2.5 


162 


2.3 


27 


5.6 


2 


_ 5 


1983 


200 


2.7 


168 


2.4 


26 


5.6 


5 


3.1 


1984 


227 


2.9 


190 


2.6 


33 


6.6 


5 


2.9 


1985 


207 


2.5 


161 


2.1 


41 


7.8 


6 


3.3 


1986 


217 


2.6 


177 


2.3 


34 


6.1 


6 


2.5 


1987 


176 


2.1 


143 


1.8 


30 


4.8 


3 


__5 


1988 


216 


2.5 


163 


2.1 


46 


6.7 


7 


2.0 


1989 


218 


2.4 


173 


2.1 


36 


4.9 


9 


2.5 


1990 


203 


2.2 


172 


2.1 


26 


3.4 


5 


1.4 


1991 


176 


2.0 


142 


1.8 


30 


4.1 


4 


__5 


1992 


154 


1.8 


113 


1.5 


35 


4.8 


6 


1.7 


1993 


148 


1.7 


123 


1.7 


21 


3.0 


4 


__5 


1994 


150 


1.8 


127 


1.7 


21 


3.1 


2 


_5 


1995 


121 


1.5 


96 


1.3 


15 


2.4 


10 


2.6 


1996 


113 


1.4 


80 


1.1 


30 


5.0 


3 


_5 


1997 


102 


1.3 


78 


1.1 


21 


3.4 


3 


_5 


1998 


99 


1.2 


84 


1.2 


12 


1.9 


3 


_5 


1999 


86 


1.1 


69 


1.0 


14 


2.1 


3 


5 


2000 


89 


1.1 


66 


0.9 


18 


2.8 


5 


1.0 


2001 


99 


1.2 


75 


1.1 


18 


2.7 


6 


1.1 


2002 


98 


1.2 


71 


1.0 


23 


3.4 


4 


_ 5 


2003 


98 


1.2 


73 


1.1 


20 


3.0 


5 


0.9 



1. Hispanic origin could not be identified from the Massachusetts death certificate before 1989; thus, Hispanic trend data are 
not available. Most Hispanics are included in the race category of White. Hispanic infant mortality data for the years 1 990 
through 2003 are presented in Table D-1 . 2. Deaths of infants of unknown race are included in the total calculation. For rate 
computations, infants of unknown race are allocated into the race categories according to the distribution of births of known 
race. 3. Other. American Indian and Other races. 4. Rates are expressed per 1 ,000 live births. 5. Calculations based on 
fewer than five events are excluded. 



168 



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Figure D-3. Infant Mortality Rates 
Massachusetts: 1 842-2003 1 



220 -r 
200 -■ 




1840 1850 1860 1870 1880 1890 1900 1910 1920 1930 1940 1950 1960 1970 1980 1990 2000 

Year 



1. Data not available for 1850. 



MARRIAGES & DIVORCES 



SECTION E 



MARRIAGES AND DIVORCES 

Marriages are reported by city or town of occurrence in Massachusetts. For example, if two 
Boston residents are married in Barnstable, this marriage will be reported by place of 
occurrence (Barnstable) rather than the residence of the couple (Boston). Marriages have 
traditionally been reported in this manner because of the number of couples who live in 
different communities from the town of marriage. Additionally, out-of-state residents who 
marry in Massachusetts are included in these data. Divorces are reported by the county of 
final judgment via the probate court. 

Marriages and divorces which involve Massachusetts residents, but occur in other states, 
are not included in these figures. No system of interstate exchange exists for these events. 
Unlike some states, Massachusetts marriage and divorce laws neither encourage out-of- 
state residents to come to the state nor discourage residents from using the 
Massachusetts system by imposing long waiting periods, etc. 

In 2003, 36,224 marriages occurred in Massachusetts compared to 37,735 in 2002, a 
decrease of 4.0%. The rate of marriages was at 5.9 per 1,000 population in 2002 and 5.6 in 
2003. The 2003 US rate of marriages per 1,000 population was 7.5, slightly lower than the 
2002 US rate of 7.8. Of all brides in Massachusetts in 2003, 73.8% had not previously been 
married. This percentage was slightly lower among the grooms--72.4%. 

In 2003, 15,738 divorces were granted in Massachusetts, a decrease of 3.2% from the 
16,253 divorces granted in 2002. The 2003 rate of divorce per 1,000 population in 
Massachusetts was 2.4, slightly below the 2002 divorce rate of 2.5. The 2003 
Massachusetts rate was well below the 2003 US rate of 3.8 divorces per 1,000 population. 



RATES IMPORTANT FOR THIS SECTION INCLUDE : 

MARRIAGE RATE Number of Occurrence Marriages x 1,000 

Total Population 

DIVORCE RATE Number of Occurrence Divorces x 1,000 

Total Population 



173 




174 



Table E-1. Marriages and Divorces by County 
Massachusetts Occurrence: 2003 




Marriaqes 1 


Divorces 


State Total 


36,224 


15,738 


Counties 






Barnstable 


2,505 


594 


Berkshire 


884 


328 


Bristol 


2,823 


1546 


Dukes 


428 


17 


Essex 


3,864 


1889 


Franklin 


393 


290 


Hampden 


2,565 


951 


Hampshire 


745 


375 


Middlesex 


7,290 


2681 


Nantucket 


265 


37 


Norfolk 


3,279 


1555 


Plymouth 


2,476 


1401 


Suffolk 


4,311 


1766 


Worcester 


4,394 


2308 



1 2 marriages in unknown county 



175 



Table E-2. Marriages and Divorces: Numbers and Rates per 1,000 Population 

■ Massachusetts Occurrence, Selected Years: 1900-2003 

Marriages Divorces 



Vo o r 


M 1 1 m hor 
INUI 1 lUt! I 


Rata 
r\cllc 


INUI 1 lUtM 


Rata 
r\aie 


1900 


24,342 


8.7 


1,258 


0.4 


1905 


27,184 


9.1 


1,554 


0.5 


1910 


30,710 


9.1 


1,929 


0.6 


1915 


31,301 


8.5 


2,252 


0.6 


1920 


38,048 


9.9 


3,647 


1.0 


1925 


31,238 


7.5 


3,395 


0.8 


1930 


27,431 


6.5 


3,746 


0.9 


1935 


30,019 


6.9 


4,081 


0.9 


1940 


44,836 


10.4 


4,502 


1.0 


1945 • 


38,197 


8.5 


6,833 


1.5 


1950 


41,711 


8.9 


6,365 


1.4 


1955 


35,585 


7.3 


5,601 


1.2 


1960 


34,050 


6.6 


5,592 


1.1 


1965 


38,281 


7.2 


7,728 


1.5 


1 07f> 

i y fu 


A7 OQO 
H 1 ,ZMlL 


O.J 


I U,o I o 


1 Q 


1975 


42,103 


7.3 


16,460 


2.8 


1980 


46,273 


8.1 


17,873 


3.1 


1985 


49,849 


8.6 


21,573 


3.7 


1986 


49,990 


8.6 


19,809 


3.4 


1987 


49,034 


8.4 


16,994 


2.9 


1988 


49,941 


8.5 


17.676 


3.0 


1989 


49,174 


8.4 


16,819 


2.9 


1990 


47,786 


7.9 


16,258 


2.7 


1991 


44,621 


7.4 


14,987 


2.5 


1992 


43,228 


7.1 


15,411 


2.5 


1993 


42,355 


7.0 


14,435 


2.4 


1994 


42,503 


7.0 


15,450 


2.5 


1995 


41,522 


6.8 


15,772 


2.6 


1996 


41,234 


6.7 


15,485 


2.5 


1997 


41,528 


6.7 


15,942 


2.6 


1998 


38,722 


6.2 


16,010 


2.6 


1999 


39,425 


6.2 


15,632 


2.5 


2000 


38,603 


6.1 


15,980 


2.5 


2001 


40,048 


6.3 


15,324 


2.4 


2002 


37,735 


5.9 


15,253 


2.5 


2003 


36,224 


5.6 


15,738 


2.4 



176 



Table E-3. Marriages by Age and Marital Status 



Massachusetts Occurrence: 2003 











Bride 












Total 




Single 




Widowed 


Divorced 


Age 


Number 


% 


Number 


% 


Number 


% 


Number 


% 


Total 


36,218 


100.0% 


26,735 


73.8% 


776 


2.1% 


8,707 


24.0% 


<20 


933 


100.0% 


930 


99.7% 





0.0% 


3 


0.3% 


20-29 


17,008 


100.0% 


16,214 


95.3% 


18 


0.1% 


776 


4.6% 


30-39 


A A AFC 

1 1,455 


1 00.0% 


7,914 


69.1% 


102 


0.9% 


3,439 


30.0% 


40-49 


4,546 


100.0% 


1,410 


31.0% 


207 


4.6% 


2,929 


64.4% 


50-59 


1,682 


100.0% 


226 


13.4% 


177 


10.5% 


1,279 


76.0% 


60-69 


453 


100.0% 


35 


7.7% 


168 


37.1% 


250 


55.2% 


70+ 


141 


100.0% 


6 


4.3% 


104 


73.8% 


31 


22.0% 








Groom 












Total 




Single 




Widowed 


Divorced 


Age 


Number 


% 


Number 


% 


Number 


% 


Number 


% 


Total 


36,220 


100.0% 


26,226 


72.4% 


790 


2.2% 


9,204 


25.4% 


<20 


292 


100.0% 


292 


100.0% 





0.0% 





0.0% 


20-29 


13,761 


100.0% 


13,345 


97.0% 


8 


0.1% 


408 


3.0% 


30-39 


13,387 


100.0% 


10,287 


76.8% 


42 


0.3% 


3,058 


22.8% 


40-49 


5,244 


100.0% 


1,849 


35.3% 


109 


2.1% 


3,286 


62.7% 


50-59 


2,371 


100.0% 


379 


16.0% 


171 


7.2% 


1,821 


76.8% 


60-69 


819 


100.0% 


58 


7.1% 


224 


27.4% 


537 


65.6% 


70+ 


346 


100.0% 


16 


4.6% 


236 


68.2% 


94 


27.2% 



Note: 6 brides and 4 grooms are not included due to missing information. 



177 





Table E-4. Number of Marriages by Age of Bride and Age of Groom, 








Massachusetts Occurrence: 2003 
















Age of Groom 








Age of 
Bride 


Total 


<zU 


zU - zy 


30-39 


40-49 


50-59 


60-69 


70+ 


Total 


36,221 


292 


13,761 


13,387 


5,244 


2,372 


819 


346 


<20 


933 


165 


678 


77 


11 


2 








20-29 


17,008 


116 


A A O O ~7 

11,327 


5,048 


451 


56 


10 





30-39 


1 1 ,456 


9 


1 ,636 


7,203 


2,245 


322 


38 


3 


40-49 


4,547 


2 


109 


988 


2,185 


1,077 


160 


26 


50-59 


1,683 





8 


66 


333 


839 


370 


67 


60-69 


453 





2 


4 


18 


69 


225 


135 


70+ 


141 





1 


1 


1 


7 


16 


115 



Note: Table does not include 3 marriages with missing age information. 



Table E-5. Number of Marriages for Bride by Number of Marriages for Groom 

Massachusetts Occurrence: 2003 






Number of Marriages 
Groom 








Bride 


Total 


1 


2 


3 


4 


5+ 


Total 


36,224 


26,231 


8,291 


1,495 


184 


23 


1 


26,739 


22,552 


3,736 


407 


39 


5 


2 


7,871 


3,294 


3,697 


771 


100 


9 


3 


1,425 


341 


771 


275 


32 


6 


4 


157 


39 


67 


37 


12 


2 


5+ 


32 


5 


20 


5 


1 


1 



178 



POPULATION 



SECTION F 



POPULATION 



The population data in this section are presented for use in computing rates for small areas 
and for reporting changes over time by municipality and county. They are based primarily 
on the US Federal Census for 2000. 

All additional interpolations and calculations have been provided by Bruce B. Cohen and 
James West, Division of Research and Epidemiology, Bureau of Health Information, 
Statistics, Research and Evaluation, Massachusetts Department of Public Health. 

In 2003, there were an estimated 6,442,506 residents of Massachusetts. This represents an 
8.6% increase in population since 1987, when the population numbered 5,932,611. Among 
the total 2003 population in Massachusetts, 48.4% were male, 25.5% were below the age of 
20, and 7.0% were over 75 years of age. 



179 




180 





Table F-1 


Population by Race, Age, and Sex; Massachusetts:2003 












White, 


Black, 


Asian, 




Amer. Indian, 




Sex 


Total Non-Hispanic Non-Hispanic Non-Hispanic 


Hispanic 


Non-Hispanic 


0-4 


Male 


202,150 


148,397 


16,575 


11,011 


25,801 


366 




Female 


192,897 


141,445 


15,778 


10,683 


24,616 


375 




Total 


395,047 


289,842 


32,353 


21,694 


50,417 


741 


5-9 


Male 


204,666 


155,777 


15,720 


9,624 


23,027 


518 




Female 


195,375 


147,906 


14,968 


10,031 


21,982 


488 




Total 


400,041 


303,683 


30,688 


19,655 


45,009 


1,006 


10-14 


Male 


222,868 


170,787 


17,717 


9,596 


24,159 


609 




Female 


211,728 


161,902 


17,199 


9,042 


22,986 


599 




Total 


434,596 


332,689 


34,916 


18,638 


47,145 


1,208 


15-19 


Male 


213,161 


165,917 


15,910 


9,912 


20,822 


600 




Female 


202,109 


156,840 


15,137 


10,346 


19,208 


578 




Total 


415,270 


322,757 


31,047 


20,258 


40,030 


1,178 


20-24 


Male 


216,030 


160,065 


16,006 


13,795 


25,532 


632 




Female 


217,867 


161,714 


16.452 


15,127 


23,935 


639 




Total 


433,897 


321,779 


32,458 


28,922 


49,467 


1,271 


25-29 


Male 


205,376 


150,366 


14,005 


16,361 


24,126 


518 




Female 


211,325 


155,746 


14,804 


22,944 


17,320 


511 




Total 


416,701 


306,112 


28,809 


39,305 


41,446 


1,029 


30-34 


Male 


233,136 


178,840 


14,193 


17,600 


21,980 


523 




Female 


240,717 


184,891 


15,737 


17,423 


22,112 


554 




Total 


473,853 


363,731 


29,930 


35,023 


44,092 


1,077 


35-39 


Male 


253,838 


204,578 


14,874 


13,797 


19,992 


597 




Female 


261,622 


210,359 


16,158 


20,885 


13,620 


600 




Total 


515,460 


414,937 


31,032 


34,682 


33,612 


1,197 


40-44 


Male 


264,898 


222,139 


14,625 


1 1 ,248 


16,223 


663 




Female 


273,069 


228,333 


15,761 


10,971 


17,328 


676 




Total 


537,967 


450,472 


30,386 


22,219 


33,551 


1,339 


45-49 


Male 


243,290 


209,781 


12,349 


8,737 


11,834 


589 




Female 


255,107 


218,928 


13,028 


9,370 


13,147 


634 




Total 


498,397 


428,709 


25,377 


18,107 


24,981 


1,223 


50-54 


Male 


210,453 


184,858 


9,570 


7,019 


8,502 


504 




Female 


223,678 


195,074 


10,780 


7,449 


9,868 


507 




Total 


434,131 


379,932 


20,350 


14,468 


18,370 


1,011 



181 



Table F-1. (Continued) Population by Race, Age, and Sex; Massachusetts:2003 



Age 


Sex 


White, Black, Asian, 
Total Non-Hispanic Non-Hispanic Non-Hispanic 


Hispanic 


Amer. Indian, 
Non-Hispanic 




IVIdlc 


174,457 


156,279 


6,927 


4,820 


R 07? 


OOO 




Female 


188,956 


167,635 


8,461 


5,028 


7,435 


397 




Total 


?fi? 41*3 


Ot.O , c7 1 H 


1 ^ ?88 
1 0,000 


Q 848 
%y, oho 


13,508 


755 




IvldlC 


126,808 


113,941 


4,954 


3,530 


4 101 


<LO£. 




Female 


141,106 


125,772 


6,278 


3,828 


4,965 


263 




Total 


t-\J 1 ,v7 1 *T 


9?Q 71? 




7 358 


9,066 


545 




1 Via It; 


95,452 


86,358 


3,579 


2,761 




1Q? 




Female 


110,398 


99,035 


4,778 


2,915 


3,509 


161 




Total 


90S 8S0 


1 OO jOvjO 


8 3^7 


5 fi7fi 


6,070 


354 


70-74 


1 vld 1 C 


85,632 


79,014 


2,665 


2,057 


1 755 


141 




Female 


111,009 


101,812 


4,008 


2,420 


2,604 


165 




Total 


196 641 


180 826 


6 673 


4,477 


4,359 


306 






75,076 


70,352 


1,962 


1,363 


1,276 


123 




Female 


108,117 


101,157 


3,229 


1,798 


1,817 


116 




Total 


183 193 


171,509 


5,191 


3,161 


3,093 


239 


80-84 




50,760 


48,069 


1,157 


776 


707 


51 




Female 


88,112 


83,429 


2,301 


1,113 


1,147 


122 




Total 


138,872 


131,498 


3,458 


1,889 


1,854 


173 


85+ 


Male 


38,236 


36,141 


908 


540 


598 


49 




Female 


93,028 


88,854 


2,007 


884 


1,160 


123 




Total 


131,264 


124,995 


2,915 


1,424 


1,758 


172 


Total 


Male 


3,116,287 


2,541,659 


183,696 


144,547 


239,069 


7,316 




Female 


3,326,220 


2,730,832 


196,864 


162,257 


228,759 


7,508 




Total 


6,442,506 


5,272,491 


380,560 


306,804 


467,828 


14,824 



*Numbers do not sum to total due to rounding in the algorithm 



182 




183 




184 



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186 



Table F-3. Massachusetts Population by City and Town: 1980, 1990, and 2000 US Census 



City /Town 


1980 


1990 


2000 


City/Town 


1980 


1990 


2000 


ABINGTON 


13,517 


13,817 


15,111 


CAMBRIDGE 


95,322 


95,802 


98,868 


ACTON 


17,544 


17,872 


20,189 


/~\ a Ik IT/ - \ A 1 

CANTON 


18.182 


18,530 


20,530 


ACUSHNET 


8,704 


9,554 


10.604 


CARLISLE 


3,306 


4.333 


4,634 


ADAMS 


10,381 


9,445 


8,829 


CARVER 


6,988 


10,590 


11,414 


A J— \ 1 111 > 1 * 

AGAWAM 


26,271 


27,323 


28,845 


/-\ i i a nil r - a t /~\ k it 

CHARLEMONT 


1,149 


1,249 


1,325 


ALFORD 


394 


418 


417 


CHARLTON 


6.719 


9,576 


11,242 


a ft iccoi mv 

AMbSBURY 


13,971 


14,997 


16,271 


ON A T-| 1 A ft J 

CHA 1 HAM 


6,071 


6,579 


6,728 


A 1 Ml II — OOT" 

AMHERST 


33,229 


35,228 


37,891 


CHbLMorORU 


31,174 


32,383 


34,524 


ANDOVER 


26,370 


29,151 


31,590 


{CHELSEA 


25,431 


28,710 


31,956 


A /"\i II k ii I A u /r» a\/ i m * n\ 

AQUINNAH (GAY HEAD) 


220 


201 


314 


^CHESHIRE 


3,124 


3,479 


3,657 


ARLINGTON 


48,219 


44,630 


42,776 


Onbo 1 bR 


1,123 


1,280 


1,402 


a pi mi inkiu ah 

ASHBURNHAM 


4,075 


5,433 


5,948 


j CHESTERFIELD 


1,000 


1.048 


1,162 


ASHBY 


2,311 


' 2,717 


2,793 


jCHICOPEE 


55,112 


56,632 


53,873 


ASHFIELD 


1,458 


1,715 


1,849 


i J ii ft j a n iy 

CHILMARK 


489 


650 


818 


ASHLAND 


9,165 


12,066 


14,415 


CLARKSBURG 


1,871 


1,745 


1,772 


ATHOL 


10,634 


11,451 


11,330 


CLINTON 


12,771 


13,222 


13,508 


a tti r~r>/^o/^ 

ATTLcBORO 


34,196 


38,383 


41,282 


/"» /*M_I A O O r~T 

COHASSET 


7,174 


7,075 


7,463 


A 1 mi (OKI 

AUBURN 


14,845 


15,005 


15,783 


COLRAIN 


1,552 


1,757 


1,825 


AVUN 


5,026 


4,558 


4,460 


OUNCURU 


16,293 


17,076 


18,271 


A VCD 

AYbK 


6,993 


6,871 


6,288 


OUNWAY 


1,213 


1,529 


1,811 


DADMCTADI C 

dAKNo I Ad Lb 


30,898 


40,949 


47,188 


OUMMINO 1 UN 


657 


785 


917 


n> a nnr 

BAKKb 


4,102 


4,546 


5,144 


UAL 1 UN 


6,797 


7,155 


6,876 


BbOKcT 


1,339 


1,481 


1,754 


r\ a Kl\ /CDC 

UANVbRo 


24,100 


24,174 


25,523 


BcDPORD 


13,067 


12,996 


12,289 


UAR 1 MUU 1 H 


23,966 


27,244 


31,019 


ri f - 1 /~M I f - DTAl A /ft 1 

BELCHERTOWN 


8,339 


10,579 


12,844 


r~\ r — |—\ ii a ft i 

DEDHAM 


25,298 


23,782 


23,288 


O f — | | | ft |/"*LJ A ft J 

BELLINGHAM 


14,300 


14,877 


15,567 


r~\ t — f — nnr"i i™\ 

DEERFIELD 


4,517 


5,018 


5,109 


BtLMUN I 


26,100 


24,720 


25,035 


UhNNIb 


12,360 


13,864 


15,139 


BbKKLfcY 


2,731 


4,237 


5,750 


□lUH 1 UN 


5,352 


5,631 


6,316 


nrni III 

BtKLIN 


2,215 


2,293 


2,386 


UUUULAb 


3,730 


5,438 


6,744 


DCDMADnCTAM 
DtKNAKUo 1 UN 


1,750 


2,048 


2,1 19 


UUVfcK 


4,703 


4,915 


C 7CO 

o,7oo 


RPVPRI V 


07 CCC 

Of ,000 


00,1 30 


40,210 


nPAn IT 
UKMUU 1 


r\A OJ A 

21,24y 


OC cod 

2o,oy4 


OQ CQC 

ZO.OOO 


D 1 LLcnUL-M 


00,727 


07 caa 

o/,60y 


o o coo 

38,688 


ni ir\i pv 

UUULtT 


O "7 A T 

8,717 


A c a n 

y,o4o 


A A AAA 

lo.uuy 


OL/\OI\0 1 UNt 


6,570 


O AOO 

8,023 


(~i AAA 

9,020 


Rl IMCTADI C 
UUNo 1 AOLt 


1,671 


o 

2,200 


O QAQ 

2,oyo 


DLrMNUrUrvU 


A ftOQ 

1,000 


A A 07 

1,10/ 


1,212 


DUXBURY 


A A OAT 

11,80/ 


A O Q AC 

io,oyo 


i A QAO 
14,00^ 


OOI TDM 


o cqa 
2,000 


O A1A 

o,lo4 


4.239 


EAST BRIDGEWATER 


A A/1 C 

y,y4o 


AAA f\A 
1 1 , 1U4 


A O. OOO 


DUO 1 UN 


ceo aa>i 
0b2,yy4 


0/4, 2oo 


576,554 


EAST BROOKFIELD 


A OCC 

1,955 


O AQ0 

2,0oo 


Z, TOO 


DUUKNC 


13,874 


A C AO A 

16,064 


17,834 


EAST LONGMEADOW 


A A AAC 

12,905 


A o OC7 
10,00/ 


1 < IOC 

14,400 


Rnvpnpni ir;w 

DUAdUrvUUon 


3,126 


O O A O 

0,343 


4,788 


EASTHAM 


0,472 


4,4o2 


C 1 7H 
0,1 (U 


DUATUKU 


C 17jI 

5,374 


6,266 


8,378 


EASTHAMPTON 


15,580 


A C C07 

lo.ooY 


i o.yoo 


RfWI QTOM 
DU T Lo 1 UN 


o ji 7n 
0,4/0 


O C -4 7 

0,51 / 


3,907 jEASTON 


A C COO 

16,o2o 


A A QA7 


OO A *37 


RR A IMTRPP 


OC 007 

o6,o37 


OO 07C 

33,836 


34.095 ! 


EDGARTOWN 


O OA A 

2,204 


no 
0,0o2 


*3 Q7H 
0,0/0 


Dr\PvVo 1 Ci\ 


0,22b 


O A A a 

0,440 


10,110 


EGREMONT 


A *3A A 

l.oll 


a OOQ 


i ,0 iz 


RRIDPPWATPR 


17,202 


21,249 


25,480 


ERVING 


1,326 


A T7 O 

1,372 


1 ,4o4 


BRIMFIELD 


2.318 


3.001 


3,358 


ESSEX 


2,998 


3.260 


3,240 


BROCKTON 


95,172 


92,788 


92.700 


EVERETT 


37,195 


35.701 


37,494 


BROOKFIELD 


2,397 


2,968 


3.136 


FAIRHAVEN 


15.759 


16,132 


16,119 


BROOKLINE 


55,062 


54,718 


58,917 [FALL RIVER 


92,574 


92,703 


90,655 


BUCKLAND 


1,864 


1.928 


1,973 | FALMOUTH 


23,640 


27,960 


30,970 


BURLINGTON 


23,486 


23,302 


24,082 | 


FITCHBURG 


39,580 


41,194 


39,613 



187 



Table F-3 (continued). Massachusetts Population by City and Town: 1980, 1990, and 2000 US Census 



City/Town 


1980 


1990 


2000 


City/Town 


1980 


1990 


2000 


FLORIDA 


730 


742 


768 


LANESBOROUGH 


3,131 


3,032 


3,110 


FOXBOROUGH 


14,148 


14,637 


16,462 


i a \ a / n r~ ft i t~ 

LAWRENCE 


63,175 


70,207 


71,228 


r~n a ft Jlftv A ft A 

FRAMINGHAM 


65,113 


64,989 


66,773 


LEE 


6,247 


5,849 


5,937 


r~o A ft ii/i 1 ft 1 

FRANKLIN 


18,217 


22,095 


29,267 


LEICESTER 


9,446 


10,191 


10,439 


rKfctlUWN 


7,058 


8,522 


8,896 


LtNUX 


6,523 


5,069 


4,931 


GAKUNbK 


17,900 


20,125 


21,154 


LbUMINo 1 tK 


34,508 


38,145 


41,631 


GbOKGb 1 UWN 


5,687 


6,384 


7,543 


1 DtiCDC 1 1 

Lb V bKt 1 1 


1,471 


1,785 


1,867 


GILL 


1,259 


1,583 


1,523 


LbAlNG 1 UN 


29,479 


28,974 


31,090 


GLOUGbo 1 fcK 


27,768 


28,716 


29,905 


LbYUbN 


498 


662 


777 


GOonbN 


651 


830 


923 


LINOULN 


7,098 


7,666 


8,563 


GOoNOLU 


63 


98 


123 


1 111! CTAti 

LI 1 1 Lb 1 ON 


6,970 


7,051 


8,048 


GRAFTON 


11,238 


13,035 


14,881 


LUNGMbAUOW 


16,301 


15,467 


1 5,460 


GRANBY 


5,380 


5,565 


6,063 


LOWbLL 


92,418 


103,439 


105,854 


GRANVILLE 


1,204 


1,403 


1,518 


LUULOW 


18,150 


18,820 


1 9,693 


/■•OCAT DADDIKIPTAKI 

GKtAl dAKKINCjIUN 


7,405 


7,725 


7,828 


LUNbNbUKG 


8,405 


9,117 


9,394 


GKtcNrltLU 


18,436 


18,666 


18,031 


1 VMM 

LYNN 


78,471 


81,245 


86,298 


bKU 1 UN 


6,154 


7,511 


9,401 


LYNNrlbLU 


1 1 ,267 


11,274 


11,799 


bKUVtLAINU 


5,040 


C 0«* A 

5,214 


6,041 


MALUbIN 


53,386 


53,884 


55,064 


HADLfcY 


4,125 


4,231 


4,663 


MANOnto 1 bK 


5,424 


5,286 


5,391 


l_l A 1 ICAV 

HALIFAX 


5,513 


6,526 


7,513 


MANbrlbLD 


13,453 


16,568 


21,476 


ii A ft J 1 1 TAM 

HAMILTON 


6,960 


7,280 


8,427 


MAKbLbnbAU 


20,126 


1 9,97.1 


20,771 


UAUDACKI 

HAMrUhN 


4,745 


4,709 


4,891 


MAKIUIN 


3,932 


4,496 


o.ooU 


HANOUOK 


643 


628 


727 


MAKLbUKUUGM 


30,617 


31,813 


35,157 


l_| A MAV/CD 

HANUVtK 


11,358 


11,912 


13,412 


UADCUCICI Pi 


20,916 


21,531 


oo ooo 
23,822 


UAMCAM 

HANoUN 


8,617 


9,028 


9,429 


AAA OUDCC 

MAoMrbb 


3,700 


7,884 


A A ceo 
11,000 


lj a Dn\A/ir x w 


2,272 


1 ooc 

2,385 


O CO 4 

2,oo4 


fiATTADniCCTT 
MAI 1 ArUlotl 1 


C CAT 

5,597 


o.ooU 


C Oyf O 

0,243 


WAD\/A n n 
nnKVnKU 


4 O 4 "7 A 

12,1 /U 


i2,o2y 


A OOC 


MATINAKU 


A CAA 

y,5yu 


1U,o<io 


i A CQC 
iU.OOO 


n/\r\ vv ion 


O AT -4 

o,y/i 


lU,2/5 


4 H QOQ 

i 1,o2o 


MburibLU 


A r\ OOA 

1U.22U 


10,00 1 


•lO 01 o 


hatpipi n 


O.U40 


9 -1 QA 

o,1o4 


O OAC 




CO f\7C 


C7 A C\1 
Of ,4Uf 


CC QAC 

oo.yno 


HAVFRHII 1 
nnv crvn i i_l 


40,000 


1 /IIP 

01 ,41 


oo,i i y 


MFnWAY 
ivil_u/ v v r\ i 


Q AA7 
0,44/ 




I Z , I U I 


MAWI PY 


20U 


Ol / 


OOQ 

ooy 


rvici_r\^OL 


on nt^cz 


OP 1 Cfi 


zo,y i z 


HPATH 


402 


7 A. C 


QOO 

022 


MFwnnw 

IVICINUV^IN 


O lAfl 

o,lUo 




C. 19C 
O, I A-D 


HIKIi^H AM 

n i in on/-\ m 


2U,ooy 


i y,o2i 


on con 


1V1 C rv r\ 1 IV1AO 


A AR4 
4,401 


o,i DO 


R 0.07 


HiKicnAi p 




i ACQ 

i ,yoy 


2,uuy 


MPTHI IFM 


7H1 

oo, / in 


on QQA 


/19 Qfifi 


hoi RRnnk" 


11,1 4U 


-t 1 n -i 1 
1 1 ,U41 


1 1 t Ul / 


ivi i \j u l ci d kj T\ \j yj o n 


1D.4U4 


*l 7 ftC:7 


1Q Qf?^ 

i y,yoo 


wni nPM 


10,000 


14,02(5 


I C Q7C 
1 O.O/O 


Kyimni ffipi n 

IVI 1 \J L/ L C I 1 E L_ U 




OQO 


ouo 


nni i AMn 


4 eon 

i ,ooy 


2, loo 


O vl "1 O 


k/iinni ftdni 

MIUULC 1 UIN 


A 1 OC 

4,1oO 


4,3/ I 


/ ,uoo 


nULulO 1 WIN 


1 O AOO 


1 O QOA 


1/1 400 
14,4oZ 


mii priRn 


oo oon 


OC OCC 
iiJ,0JJ 




l_ini YDk'F 


44,0/0 


vIO 7C\A 

4J./U4 


>IA CA/i 

4U.0U4 


MM 1 PI IRY 


4 4 QAO 

1 1 ,ouo 


19 OOP 




HOPPnAI P 
nUr CUnLC 


o one 


0,000 


C H71 
D,U/ 1 


MII 1 ic; 
rviii.i_lo 


o.yuo 


7 fi1 
/ ,D I 


7 ft^fi 




/ ,1 14 


y,i yi 


■JO 7CC 

12,/ DO 


Mil 1 VII 1 P 


1 AQO 

i ,oyo 




2 786 


HIJRBARDSTON 


1 7Q7 

i , / y # 


9 7Q7 


O OA A 


MILTON 

IVII L. 1 \J\ 




25 725 


26,725 


HUDSON 


16,408 


17,233 


17,951 


MONROE 


179 


115 


102 


HULL 


9,714 


10,466 


11,200 


MONSON 


7,315 


7,776 


8,835 


HUNTINGTON 


1,804 


1,987 


2,236 


MONTAGUE 


8,011 


8,316 


8,095 


IPSWICH 


11,158 


11,873 


12,566 


MONTEREY 


818 


805 


925 


KINGSTON 


7,362 


9,045 


11,242 


MONTGOMERY 


637 


759 


709 


LAKEVILLE 


5,931 


7,785 


9,668 


MOUNT WASHINGTON 


93 


135 


152 


LANCASTER 


6,334 


6,661 


7,432 


NAHANT 


3,947 


3,828 


3,748 



188 



Table F-3 i continued). Massachusetts Population by City and Town: 1980, 1990, and 2000 US Cens 


us 


City/Town 


1980 


1990 


2000 


City/Town 


1980 


1990 


2000 


NANTUCKET 


5,087 


6,012 


8,651 


READING 


22,678 


22,539 


23,953 


NATICK 


29,461 


30,510 


32,094 


REHOBOTH 


7,570 


8,656 


10,188 


NEEDHAM 


27,901 


27,557 


28,427 


REVERE 


42.423 


42,786 


43,681 


NEW ASHFORD 


159 


192 


238 


1 — i | , — ■ | ■ a ini i r — \ 

RICHMOND 


1,659 


1.677 


A -w A n 

1 ,740 


NEW BEDFORD 


98,478 


99,922 


94.347 


ROCHESTER 


3,205 


3,921 


4,623 


NEW BRAINTREE 


671 


881 


997 


ROCKLAND 


15,695 


16,123 


17,608 


NEW MARLBOROUGH 


1,160 


1,240 


1,538 


ROCKPORT 


6,345 


7,462 


8,043 


NEW SALEM 


688 


802 


898 


ROWE 


336 


378 


371 


NEWBURY 


4,529 


5,623 


6.666 


ROWLEY 


3,867 


4,452 


5,434 


NEWBURYPORT 


15,900 


16.317 


16.988 


ROYALSTON 


955 


1,147 


1,205 


NEWTON 


83,622 


82,585 


87.211 


RUSSELL 


1.570 


1.594 


1,734 


NORFOLK 


6,363 


9,270 


10,506 


RUTLAND 


4,334 


4,936 


6,123 


NORTH ADAMS 


18,063 


16,797 


15,675 


SALEM 


38,220 


38.091 


40,348 


NORTH ANDOVER 


20,129 


22,792 


26,785 


SALISBURY 


5,973 


6,882 


7,554 


NORTH ATTLEBORO 


21,095 


25,038 


26,858 


SANDISFIELD 


720 


667 


OA A 

oOl 


NORTH BROOKFIELD 


4,150 


4,708 


4,893 


SANDWICH 


8,727 


15,489 


a a aao 


NORTH READING 


1 1 ,455 


12,002 


13,250 


SAUGUS 


24,746 


25,549 


OC O AO 


NORTHAMPTON 


29,286 


29,289 


29,435 


SAVOY 


644 


634 


CAT 

697 


NORTHBOROUGH 


10,568 


1 1 ,929 


13.698 


SCITUATE 


17,317 


16,786 


A 7 OOA 

1 7,>JoU 


NORTHBRIDGE 


12,246 


13,371 


13,573 


SEEKONK 


12,269 


13,046 


A O 7QO 

1 J,7o9 


NORTHFIELD 


2,386 


2,838 


2,955 [SHARON 


13,601 


15,517 


17,276 


NORTON 


12,690 


14,265 


17.214 


SHEFFIELD 


2,743 


2,910 


3,347 


NORWELL 


9,182 


9,279 


9,981 
28.779 


SHELBURNE 


2,002 


2,012 


O A "TO 

2,178 


k 1 /~\ l""\t A f /—\ f-\ 

NORWOOD 


29,711 


28,700 


SHERBORN 


4,049 


3,989 


A *~>QA 

4,2o4 


OAK BLUFFS 


1,984 


2,804 


3.692 


SHIRLEY 


5,124 


6,118 


7 A A O 

/,14o 


C~\ a |/u All 

OAKHAM 


994 


1,503 


1,762 


SHREWSBURY 


22,674 


24,146 


OA OAA 

ou, jyo 


UKANljb 


6,844 


7,312 


7,710 jSHUTESBURY 


1,049 


1,561 


1 ,yo4 


Ani c A MO 

UKLtANb 


5,306 


5,838 


6,434 (SOMERSET 

9 • 


18.813 


17,655 


a a ncy 


OTIS 


963 


1,073 


1,281 


SOMERVILLE 


77,372 


76,210 


77 OOO 
/ / ,000 


AVCADn 

UXrUKU 


1 1 ,680 


12,588 


13,457 (SOUTH HADLEY 


16,399 


16,685 


A 7 C7Q 

1 / ,0(0 


DA 1 UCD 


11,389 


12,054 


12,564 | 


SOUTHAMPTON 


4,137 


4,478 


C 0.01 


D A VTAM 

rAA 1 UN 


3,762 


4,047 


4,551 jSOUTHBOROUGH 


6,193 


6,628 


Q A 1 G 

o,4 1 y 


rtAbUUY 


45,976 


47,039 


49,595 [SOUTHBRIDGE 


16,665 


17,816 


1 1 ,4oy 


□ CI UAU 

rbLnAM 


1,112 


1,373 


1,463 | 


SOUTHWICK 


7,382 


7,667 


D QOC 

0,000 


rtMtJKU^t 


13,487 


14,544 


16,433 .^SPENCER 


10,774 


A A C A C 

1 1,645 


1 i QA7 


DCDDCDCI 1 

rbrrtKbLL 


8,061 


10,098 


1 1 ,435 


SPRINGFIELD 


152,319 


156,983 


ACA OOO 


DCDI 1 

rtKU 


633 


'779 


850 [STERLING 


5,440 


6,481 


7 41 R 
/ ,4 I D 


PPTPRCNAM 


A AOyl 

1,024 


a A o 4 

1,131 


1,212 


STOCKBRIDGE 


O OOO 

2,328 


O .AO 


Z,o I O 


rnlLLIro 1 KJVH 


953 


A A DC 

1,485 


1,814 


STONEHAM 


21,424 


22,20.5 




P ITT C CI CI n 


51 ,974 


48,622 


46,284 


STOUGHTON 


26,710 


oc 777 

2b,/ I 1 


09. \ VK 


Dl AIMCICI rk 


425 


571 


594 iSTOW 


5,144 


C OOO 

5,328 


71 ^ 


Dl AIMVII 1 C 


5,857 


6,871 


7.913 


STURBRIDGE 


5,976 


7 77C 

7,775 


O Afi9 


PI YMHI ITU 


OC QA O 


40,0U0 


51.447 


SUDBURY 


1 A f!07 


14,o3o 




PLYMPTON 


1,974 


2,384 


2,690 j 


SUNDERLAND 


2,929 


3,399 


3,792 


PRINCETON 


2,425 


3,189 


3,470 j SUTTON 


5,855 


6,824 


8,153 


PROVINCETOWN 


3,536 


3,561 


3.372 ISWAMPSCOTT 


13,837 


13,650 


14.704 


QUINCY 


84,743 


84,985 


87.570 • 


SWANSEA 


15,461 


15,411 


16,079 


RANDOLPH 


28,218 


30,093 


31.630 (TAUNTON 


45,001 


49,832 


55,183 


RAYNHAM 


9,085 


9,867 


11,525 [TEMPLETON 


6,070 


6,438 


6,955 



189 



Table F-3 (continued). Massachusetts Population by City and Town: 1980, 1990, and 2000 US Census 



City/Town 


1980 


1990 


2000 


City/Town 


1980 


1990 


2000 


TEWKSBURY 


24,635 


27.266 


29.603 


WINCHESTER 


20,701 


20,267 


20,892 


TISBURY 


2,972 


3,120 


3.674 


WINDSOR 


598 


770 


839 


TOLLAND 


235 


289 


396 


WINTHROP 


19,294 


18,127 


17,750 


TOPSFIELD 


5,709 


5,754 


6.330 


WOBURN 


36,626 


35,943 


37,148 


TOWNSEND 


7,201 


8.496 


9.424 


WORCESTER 


161.799 


169,759 


170,915 


TRURO 


1,486 


1,573 


1,960 


WORTHINGTON 


932 


1,156 


1,305 


TYNGSBOROUGH 


5,683 


8,642 


10.716 


WRENTHAM 


7.580 


9,006 


10,515 


TYRINGHAM 


344 


369 


391 


YARMOUTH 


18.449 


21,174 


23,767 


UPTON 


3,886 


4,677 


5,540 








UXBRIDGE 


8,374 


10,415 


11,752 


Statewide Totals 


5.640,985 


5,919,881 


6,349,097 


WAKEFIELD 


24.895 


24,825 


25,045 








WALES 


1,177 


1,566 


1,759 








WALPOLE 


18,859 


20,212 


23.085 








WALTHAM 


58.200 


57,878 


59.243 








WARE 


8,953 


9,808 


9.820 








WAREHAM 


18.457 


19,232 


20.575 








WARREN 


3,777 


4,437 


4.815 








WARWICK 


603 


740 


778 








WASHINGTON 


587 


615 


572 








WATERTOWN 


34.384 


33,284 


32,399 








WAYLAND 


12,170 


11,874 


13,128 








WEBSTER 


14,480 


16,196 


16,313 








WELLESLEY 


27.209 


26,615 


27,716 








WELLFLEET 


2,209 


2,493 


2,687 








WENDELL 


694 


899 


1,062 








WENHAM 


3.897 


4,212 


5,014 








WEST BOYLSTON 


6.204 


6,611 


7,508 








WEST BRIDGEWATER 


6,359 


6,389 


6,760 








WEST BROOKFIELD 


3,026 


3,532 


3,683 








WEST NEWBURY 


2,861 


3,421 


4,027 








WEST SPRINGFIELD 


27,042 


27,537 


28,425 








WEST STOCKB RIDGE 


1,280 


1,483 


1,447 








WEST TISBURY 


1,010 


1,704 


2,338 








WESTBOROUGH 


13,619 


14,133 


17,320 








WESTFIELD 


36.465 


38.372 


40,511 








WESTFORD 


13.434 


16,392 


20,130 








WESTHAMPTON 


1,137 


1,327 


1,515 








WESTMINSTER 


5,139 


6,191 


7,014 








WESTON 


11,169 


10,200 


11,316 








WESTPORT 


13,763 


13,852 


14.805 








WESTWOOD 


13,212 


12,557 


14.015 








WEYMOUTH 


55,601 


54,063 


53,878 








WHATELY 


1,341 


1,375 


1.466 








WHITMAN 


13.534 


13,240 


13,580 








WILBRAHAM 


12,053 


12,635 


13,478 








WILLIAMSBURG 


2.237 


2,515 


2,599 








WILLIAMSTOWN 


8.741 


8,220 


8,731 








WILMINGTON 


17.471 


17,651 


20,839 








WINCHENDON 


7,019 


8,805 


9,532 









190 



Table F-4. Population Counts and Estimates, Massachusetts: 1980, 1985-2003 



AGE GROUP YEAR TOTAL MALE FEMALE 



0-4 


1980 


337,215 


173,029 


164,186 




1985 


379,282 


194,237 


185,045 




1990 


421,349 


215,445 


205,904 




1991 


424,617 


217,179 


207,438 




1992 


425,142 


217,537 


207,605 




1993 


424,647 


217,471 


207,176 




1994 


421,986 


216,493 


205,493 




1995 


415,741 


213,448 


202,293 




1996 


409,660 


210,345 


199,315 




1997 


404,223 


207^394 


196,829 




1998 


399,860 


204,983 


194,877 




1999 


399,310 


204,397 


194,913 




2000 


397,268 


203,062 


194,206 




2001 


390,178 


199,346 


190,832 




2002 


394,810 


201,751 


193,059 




2003 


395,047 


202,150 


192,897 


5-9 


1980 


374,734 


191,602 


183,132 




1985 


375,677 


192,542 


183,135 




1990 


376,619 


193,482 


183,137 




1991 


384,465 


197,306 


187,159 




1992 


388,956 


199,564 


189,392 




1993 


392,430 


201,241 


191,189 




1994 


399,236 


204,404 


194,832 




1995 


404,660 


206,980 


197,680 




1996 


410,066 


209,813 


200,253 




1997 


414,757 


212,313 


202,444 




1998 


414,810 


212,483 


202,327 




1999 


423,609 


217,197 


206,412 




2000 


430,861 


221,145 


209,716 




2001 


413,188 


211,921 


201,267 




2002 


408,718 


209,582 


199,136 




2003 


400,041 


204,666 


195,375 


10 - 14 


1980 


461,332 


235,669 


225,663 




1985 


404,174 


206,784 


197,390 




1990 


347,016 


177,899 


169,117 




1991 


355,502 


182,288 


173,214 




1992 


358,775 


184,070 


174,705 




1993 


363,655 


186,671 


176,984 




1994 


368,790 


189,353 


179,437 




1995 


372,452 


191,298 


181,154 




1996 


380,540 


195,292 


185,248 




1997 


388,421 


199,263 


189,158 




1998 


391,860 


200,941 


190,919 




1999 


412,311 


211.441 


200,870 




2000 


431,247 


221,168 


210,079 




2001 


431,303 


221,113 


210,190 




2002 


436,640 


223,771 


212,869 




2003 


434,596 


222,868 


211,728 



191 



Table F-4 (continued). Population Counts and Estimates, Massachusetts: 1980. 1985-2003 



AGE GROUP 



YEAR 


TOTAL 


MALE 


FEMALE 


1980 


548,239 


274,859 


273 380 


1985 


482,135 


242,074 


240 061 

« V|Vw 1 


1990 


416,030 


209,289 


206,741 


1991 


391,939 


197,402 


194,537 


1992 


383,111 


192,951 


190,160 


1993 


383,138 


192,863 


190,275 


1994 


389,017 


195,597 


193,420 


1995 


397,926 


200,053 


197,873 


1996 


407,088 


204,859 


202,229 


1997 


410,740 


207,139 


203,601 


1998 


418,478 


211,026 


207,452 


1999 


417,862 


211,120 


206,742 


2000 


415,737 


210,460 


205,277 


2001 


409,422 


209,348 


200,074 


2002 


409,688 


210,256 


199,432 


2003 


415,270 


213,161 


202,109 


1980 


552,902 


270,713 


282,189 


1985 


535,048 


263,685 


271,363 


1990 


517,194 


256,657 


260,537 


1991 


514,576 


255,360 


259,216 


1992 


516,059 


256,092 


259,967 


1993 


508,509 


252,385 


256,124 


1994 


497,732 


247,056 


250,676 


1995 


486,412 


241,442 


244,970 


1996 


469,010 


232,807 


236,203 


1997 


463.895 


230,140 


233,755 


1998 


465,352 


230,886 


234,466 


1999 


435,534 


215,192 


220,342 


2000 


404,279 


198,756 


205,523 


2001 


425,247 


209,206 


216,041 


2002 


432,849 


213,925 


218,924 


2003 


433,897 


216,030 


217,867 


1980 


489,175 


239,341 


249,834 


1985 


522,748 


258,318 


264,430 


1990 


556,320 


277,295 


279,025 


1991 


540,234 


268,978 


271,256 


1992 


529,711 


263,810 


265,901 


1993 


518,304 


258,294 


260,010 


1994 


512,557 


255,973 


256,584 


1995 


510,664 


255,351 


255,313 


1996 


514,088 


257,258 


256,830 


1997 


511,765 


256,137 


255,628 


1998 


502,345 


251,390 


250,955 


1999 


468,891 


232,721 


236,170 


2000 


434,024 


213,376 


220,648 


2001 


422,879 


208,425 


214,454 


2002 


416,009 


204,894 


211,115 


2003 


416,701 


205,376 


211,325 



15-19 



20-24 



25-29 



192 



Table F-4 (continued). Population Counts and Estimates, Massachusetts: 1980. 1985-2003 
AGE GROUP 

30-34 



35-39 



40-44 



VCAD 


l\J l ML 


MAI P 


rrpMAl P 

rCMMLt 


I \jO\J 




917 64 Q 


OOQ 7AFl 

/L/LO , I «tO 




4Q4 ^fi^ 


OA'K 17R 


OC1 100 
ZD I , I OQ 


1QQO 


RAO QQH 


968 701 


o,o^y 


1QQ1 

1 W 1 


*J*t iff £J+ 


979 10^ 


07c R91 
Z f O.Oil I 






970 956 


97^ 149 




R**Q GAR 


968 647 


971 9Qft 


1QQ4 


JO i ,OUcl 


967 676 


970 1Q4 




roq -fie. 


96^ 789 




1996 


518,478 


258,141 


260,337 


1997 


512,473 


255,510 


256,963 


1998 


SO? 999 


961 066 


9^1 Q9R 


1999 


4QR fi17 


947 106 


951 519 


2000 


492 7fi4 


249 386 


950 378 


2001 


492 792 


242 263 


950 59Q 


2002 


484 509 


238 470 


94fi 039 


2003 


473 853 


933 136 


940 717 


1980 


348 552 


169 509 


179 050 


1985 


414 863 


203 352 


911 51 1 


1990 


481 174 

~\J 1 | 1, f "T 


237 209 


943 979 


1991 


492 003 




94Q 409 


1992 


501 299 


947 990 


954 009 


1993 


508 723 


251 039 


257 684 


1994 


517,102 


25*5 251 


261 851 


1995 


522,467 


258 017 


264 450 


1996 


527,036 


260,758 


266,278 


1997 


525,899 


260,595 


265,304 


1998 


522,796 


259 389 


263,407 


1999 


532 463 


263 328 


269 135 


2000 


540 593 


266 507 


274,086 


2001 


538 710 


265 684 


273,026 


2002 


527,402 


260 018 


267,384 


2003 


515 460 


253 838 


261,622 


1980 


278,748 


134 925 


143,823 


1985 


356 061 


173,162 


182,899 


1990 


433,374 


21 1 399 


221,975 


1991 


452,459 


221,123 


231,336 


1992 


448,133 


219,257 


228,876 


1993 


450,944 


220 919 


230 025 


1994 


458,221 


224 614 


233 607 


1995 


466 848 


229 037 


237,81 1 


1996 


477,644 


234,298 


243,346 


1997 


489^729 


24036 


249^333 


1998 


496,569 


243,966 


252,603 


1999 


510,253 


250,285 


259,968 


2000 


522,402 


255,838 


266,564 


2001 


537,406 


263,687 


273,719 


2002 


537,951 


264,609 


273,342 


2003 


537,967 


264,898 


273,069 



193 



Table F-4 (continued). Population Counts and Estimates, Massachusetts: 1980, 1985-2003 


AGE GROUP YEAR 


TOTAL 


MALE 


FEMALE 


45-49 1980 


278,261 


134,444 


143,817 


1985 


305,798 


148,540 


157,258 


1990 


333,334 


162,636 


170,698 


1991 


347,758 


169,614 


178,144 


1992 


372,449 


181,639 


190,810 


1993 


388,267 


189,222 


199,045 


1994 


405,627 


197,458 


208,169 


1995 


424,194 


206,334 


217,860 


1996 


440,676 


214,576 


226,100 


1997 


439,700 


214,255 


225,445 


1998 


442,352 


215,783 


226,569 


1999 


452,918 


220,796 


232,122 


2000 


461 ,945 


225,029 


236,916 


2001 


479,151 


233,606 


245,545 


2002 


488,975 


238,190 


250,785 


2003 


498,397 


243,290 


255,107 


50 - 54 1980 


306,574 


146,211 


160,363 


1985 


284,588 


136,396 


148,192 


1990 


262,601 


126,581 


136,020 


1991 


266,799 


128,835 


137,964 


1992 


274,537 


132,602 


141,935 


1993 


291,124 


140,790 


150,334 


1994 


305,629 


148,204 


157,425 


1995 


317,854 


154,500 


163,354 


1996 


331,747 


161,214 


170,533 


1997 


359,036 


174,461 


184,575 


1998 


376,308 


182,775 


193,533 


1999 


394,565 


191,345 


203,220 


2000 


411,408 


199,205 


212,203 


2001 


437,266 


211,839 


225,427 


2002 


431,172 


208,803 


222,369 


2003 


434,131 


210,453 


223,678 


55-59 1980 


310,995 


145,603 


165,392 


1985 


281,585 


132,889 


148,696 


1990 


252,174 


120,175 


131,999 


1991 


243,598 


116,332 


127,266 


1992 


239,741 


114,800 


124,941 


1993 


238,223 


114,215 


124,008 


1994 


240,256 


115,150 


125,106 


1995 


243,035 


116,491 


126,544 


1996 


248,445 


119,247 


129,198 


1997 


258,444 


124,059 


134,385 


1998 


275,482 


132,476 


143,006 


1999 


293,440 


141,003 


152,437 


2000 


310.002 


148,841 


161,161 


2001 


325,492 


156,205 


169,287 


2002 


351,475 


168,863 


182,612 


2003 


363,413 


174,457 


188,956 



194 



Table F-4 (continued). Population Counts and Estimates, Massachusetts: 1980, 


1985-2003 


AGE GROUP YEAR 


TOTAL 


MALE 


FEMALE 


60-64 1980 


277,384 


126,323 


151,061 


1985 


269,645 


123,966 


145,679 


1990 


261,905 


121,609 


140,296 


1991 


252,853 


117,797 


135.056 


1992 


243,758 


113,682 


130,076 


1993 


236,302 


110,383 


125,919 


1994 


229,887 


107,716 


122,171 


1995 


225,426 


105,979 


119,447 


1996 


221,450 


104,381 


117,069 


1QQ7 


990 ^1 ft 


104 90fi 


116.112 


1998 


220,073 


104,333 


115,740 


1999 


228,893 


108,256 


190 


2000 


236,405 


111,504 


124,901 


2001 


244,247 


115,421 


128,826 


2002 


252,593 


119,505 


133,088 


2003 


267,914 


126,808 


141,106 


65-69 1980 


235,574 


101,023 


134,551 


1985 


243,479 


105,724 


137,755 


1990 


251,383 


110,424 


140,959 


1991 


242,200 


107,138 


135,062 


1992 


239,439 


106,603 


132,836 


1993 


236,419 


106,028 


130,391 


1994 


233,259 


105,261 


127,998 


1995 


229,328 


103,887 


125,441 


1996 


226,174 


102,090 


124,084 


1QQ7 


990 ^49 


qq 67c; 


120,667 


1998 


224,578 


102,051 


122,527 


1999 


221,157 


100,777 


1 90 ^ftO 


2000 


216,498 


98,882 


117,616 


2001 


211,693 


97,516 


114,177 


2002 


208,031 


95,834 


112,197 


2003 


205,850 


95,452 


110,398 


70-74 1980 


187,041 


73,235 


113,806 


1985 


197,186 


79,388 


117,798 


1990 


207,331 


85,541 


121,790 


1991 


206,064 


85,541 


120,523 


1992 


207,286 


86,411 


120,875 


1993 


207,610 


86,774 


120,836 


1994 


209,543 


88,009 


121,534 


1995 


211,201 


89,345 


121,856 


1996 


210,014 


88,742 


121,272 


1997 


209,512 


89,113 


120,399 


1998 


217,425 


93,318 


124,107 


1999 


214,991 


92,667 


122,324 


2000 


211,332 


91,416 


119,916 


2001 


206,665 


89,544 


117,121 


2002 


201,885 


87,724 


114,161 


2003 


196,641 


85,632 


1 1 1 ,009 



195 



Table F-4 (continued). Population Counts and Estimates, Massachusetts: 1980, 1985-2003 
AGE GROUP YEAR TOTAL MALE FEMALE 



1980 


137 828 


48,145 


89 683 


1985 


148,741 


53 591 


95,150 


1990 


1 59,653 


59,037 


100 616 


1991 


1 57,534 


59,176 


98 358 


1992 


157 819 


59,824 


97,995 


1993 


158,987 


60J52 


98^35 


1994 


161,268 


62,072 


99,196 


1995 


1 62 986 


63,262 


99,724 


1996 


166 496 


64,548 


101,948 


1997 


1 69 323 


66,029 


103,294 


1998 


178,254 


69,719 


108 535 


1999 


182,156 


72,061 


110 095 


2000 


184,941 


73,829 


111,112 


2001 


184,811 


74,287 


110,524 


2002 


184,724 


75,232 


109,492 


2003 


183 193 


75,076 


108,117 


1980 


92,180 


28,513 


63,667 


1985 


99,240 


30,991 


68,249 


1990 


106,299 


33,468 


72,831 


1991 


106,558 


33,989 


72,569 


1992 


108,271 


34,969 


73,302 


1993 


109,369 


35,782 


73,587 


1994 


110,817 


36,721 


74,096 


1995 


112,913 


37,919 


74,994 


1996 


114,039 


38,664 


75,375 


1997 


114,787 


39,273 


75,514 


1998 


121,228 


41,932 


79.296 


1999 


126,467 


44,435 


82,032 


2000 


130,699 


46,464 


84,235 


2001 


134,896 


48,601 


86,295 


2002 


136,865 


49,486 


87,379 


2003 


138,872 


50,760 


88,112 


1980 


73,908 


20,107 


53,801 


1985 


82,124 


21,006 


61,118 


1990 


90,339 


21,905 


68,434 


1991 


91,218 


22,231 


68,987 


1992 


99,184 


24,479 


74,705 


1993 


1 06^943 


26,789 


80,154 


1994 


107,996 


27,258 


80,738 


1995 


108,970 


27,600 


81,370 


1996 


111,703 


28,439 


83,264 


1997 


114,258 


29,558 


84,700 


1998 


120,501 


31,447 


89,054 


1999 


119,093 


31,435 


87,658 


2000 


116,692 


30,948 


85,744 


2001 


121,247 


33,490 


87,757 


2002 


125,466 


35,910 


89,556 


2003 


131,264 


38,236 


93,028 



196 



Table F-4. (continued) Population Counts and Estimates, Massachusetts: 1980, 1985-2003 



AGE GROUP YEAR TOTAL MALE FEMALE 



a non 

laou 


C 7*57 f\1~7 

o,io( ,\JOI 


o Tin om 


o nnc AAA 
0,UUO,144 


lyoo 


K 07C 7Q7 
0,0/ D, (Of 


o or\n qoa 

^.ouy.ozu 


O ACC fH 7 

o.Ubo.yi / 


nyyu 


ft m ft AOCZ 


O QQQ 7/1 ft 


o,l^/ ,ooU 


1 QQ -I 


c nut 1 r»-i 
o,U io.IUI 


z,oy4,yy»3 


o,\Zo, iUo 


i yy<£ 


O.IM / ,Uoo 


o one ooft 


o,l ol 


1 QQ^ 


ft nft^ «^^q 




O, IHO,il/ 4 


1994 


6,106,792 


2,944,265 


3,162,527 


1995 


6,142,812 


2,964,725 


3,178,087 


1996 


6,184,354 


2,985,472 


3,198,882 


1997 


6,227,622 


3,009,516 


3,218,106 


1998 


6,291,263 


3,039,964 


3,251,299 


1999 


6,332,530 


3,055,561 


3,276,969 


2000 


6,349,097 


3,058,816 


3,290,281 


2001 


6,406,593 


3,091,502 


3,315,091 


2002 


6,429,761 


3,106,822 


3,322,939 


2003 


6,442,506 


3,116,285 


3,326,221 



197 



APPENDICES 



:ATE NUMBER 

:-ONcn . 



iumber 



38. CRY /TOWN 




UtPAH I H t H r OF PUBLIC HEALTH 
REGISTRY OF VITAL RECORDS AMO STATISTICS 

STANOARD CERTIFICATE OF LIVE BIRTH 



3A_ FACJUTY NAME-F NOT (N FAOLITY. NUMBER AMO STREET 



3t REGISTERED NUMftfil 



NAME 



4A_ FIRST 



48 MIOfXE 



4C.LAST 



S.SEX 



6A. PCURAUTY 
(Specify Single. Tw. e«cj 



6a 81RTH OROER (« not angle. 
Specify Order. First Second. etc) 



7. TIME 



8 OAT EOF BIRTH (Month. Ojy, Year) 



JEiNCE | 



3A_ SIGNATURE (I Cert*/ *at «■' ChSU was Born Alive at Oata and T>« ard 
Place Stated) 



90. NO. t STREET 



9E. CRY/TOWN 



STATE 



9L TVPE .. 

O AT-etfTTH Q POST-NATAL Q 



NAME WA.HRST 



108 



RFTTHPLACE I IA, CRY/TOWN 




98. TYPE OR PRINT NAME 



9G. apcooe 



9C. LICENSE NUMBER 



9R OATE SIGNED (Month. Oay, Year) 



CNM D OTFLRN Q MIDWIFE D OTHER 



HO. MAOER SURNAME 



STATE/COUNTRY 



12. OATE Or BIRTH (Montfv Oay. Year) 



RESIDENCE m NUMBER AND STREET 
(Oo not use ■ 
■naXng address) 



138 OTY/TDWN 



I3C COUNTY 



I3Q STATE 



I3E3PCCOS 



ECUROYCARD 



NAME I4A.FKST 



± 



I48M100LE 



I4CLAST 



BRTHPLACE I5A. CITY/TOWN 



IS8 STATE/COUNTRY 



WTULS 
COPY • 



I7AT (WE) CEKTFY THAT THE PERSONAL N^OftMAIKlN APPEARNG ABOVE IS TRUE AND CORRECT. 



I7C. OATE SIGNED (McnKOay. Yead 



16. OATE OF BIRTH (Month. Oay. Year) 



178 RELATIONSHP TO a ID 



I7D MAJUNG ADDRESS 
(It dine<e*< kom 
item ' 13 abavel 



NUMBER AND STREET 



"CRY 



STATE 



ZPCCOE 




199 



f oh use or 
physicUks ano . 
wccmcal examiners 



<!U,e (BomtnanuifalUj afiflassadiufiena 

STANDARD CERTIFICATE OF OCATM 
RCdSTHY OF VYTAL RcXOROS AND STATISTICS 



STATE USe 
ONLY 



regctored number 



OECEDENT - NAME FIRST 



DECEDENT 



INFORMANT 



DISPOSITION' 



CERTIFIER 



£k ink only 



PLACE Of DEATH (G*rlT°~nl 

«* 



COUNTY OF OEATH 



STATE US6 ONLY 



DATE Or OtAIHf"b 0« r . r«J 
3 



hospital on o iwen oxstitution -Mm f#«K u * 



WDOWGB OB 0NOMG0 



nonotOE - Ma * st, cry/idmn. county, 

IS* 



FATHER • FULL NAME 

H 



MBtWMWrS NAME 





PLACE Of OCA tH|OhKl«*c«»(: 

S^T^Lienl Q CfVOulpJO^K OoOA jO^Nuri^gHaM O R«*«*aoco O Otf-.r*>«^W 


SOCIAL SECURITY NUMBER 
C 


*" US WAR VETERAN 
SPECIFY WAR 

7 


WAS OECEOEKT OF HSPAMK ORIGIN? . 
(Vyn, Spm&rPvmtlo Aeon; Cuamcs* Cbbon. oat-J 
CNO " OYES • 


RACE (t.g. WtHM. Bltdk. Amtrica^ tfftn. tc) 
M 


OECEDENT*S EDUCATION (Mig!i«si Gr*d« Comple1«d) 
e-r*$K(&t2) 1 a-ooaofl-<.S»- 

9 ' 


AG6.LtIlB.thir, 
|TrxJ 

Mi 


UNOER 1 YEAR 


UNDER IOAY 


OATE Of BIRTH f«*> . o«r. r>j 


WRTHPLACE <C«y on.* SUM or For-v" Cow*r/ 
II 


WOS ; DAYS 

• : 


HOURS J M*MS 

c 



USUAL OCCUPATION 



KINO OF BUSINESS OR HOUSTRY 



MAILING ADDRESS - MO. 4 ST, CITY/TOWN. STATE^ZIP COOE 
21 



7JPCODE 
lib 



\££&JC BIRTH (Wrxxk, US. 


MOTHER -NAME 


(GIVEN/ 


(UAIOEN) 


STATE Of eiRTM (f not a US. 










MM oowtffyf 


17 


U 






1* 



senassoTtansnnBN 1 — — 

□ burial Ocrematioh 

□ fxtom6ment □ removal from state 
23 □ donation □ oix.spec: 



funcaal stAvice ucfMSte 



SES8E 



RELATIONSHIP 
2Z 



PLACE Of DISPOSITION /Noma of Oiwlor. CrMMtaryaralAw) 
Mi . 



DATE OF OtSPOSITIOH 
•17 



NAWEANO AOOftESSOf f ACOJTY 



LOCATION (C«>*To«*n. SIM/ 
Mb 



29 PARI I- Emor Iho <*s*»j^i, In'ucWv (X c£xrv>i*c*t*x^* *i*t CJurt**' lh« d«a(t\. Oo rx* u»o only tf>« nvx)« of Oy*r>4. sue* as anjijc at tn&tuorf *rr*%K_ tfwc* of hoart LaAuro. 

UK *-«yona ciuao on HOll tmo (a Mwoook d|. PRINT OR TYPE LEGIBLY. 
MMSOMffi CAUSE (RmI 
. ojoMMojo of paimttm iMojobjwg 
InOVatlo. • ^ 

Sv»mj«o«u«y.fa« e u n u ia o i u . ** 
onyfaodSng H i—oo^aol - 

mil, C*J-T| winmLWHa 
CMHC(hiiM ■ H»| KM 
MIbomI mooj immMimj In 
dMoMLAST. 



ApproBifeate Intorval 
Mam Onset and Do «Ki 




lir 

if 



3€a To ffw Wrtof «ny»w«lo<V*. oT*a In 000*700* af Ino Om< 


. 0*«M. ano*fWoo* ano* duo to 0*» 


V 


caut-oft/ataloo' 






fSytrarLro 












OATE StGNEO(Wo, Oof. KrJ 


HOUROFOEATH 




3C6 


36c 


M 



~ rS-pnoojro 

IWtJ . 



NAME OF AnCNQMQ PHYSICIAN »= NOT CERnFiefl 



ajcf- _ 

f "^OATESIGNEOfUo^tWr. t*J 



,S Pfv^KHjt+CEDCxr^fTUo. c* r . r,j 

174 



NAME ANO AOORESS OF CGRIVVMQ PHYSICIAN OR MEDICAL EXAMINER (Tfpoai-PnnU 



HOUROFOEATH 
37c 



PRONOUNCED DEAO (Nr./ 
37« 



ocENse ho. of caimER ■ 

33 



WAS THERE AN R^N. 

PfoONrjUMCEM£Kr7 

YaorNO 

«0a 



F YES. DATE 


IF YES, TIME 


4HtS NAME CF PRONOUNCING RLK3ISTERJEO NURSE 




P**3NOUMCEO 


PI^ONOUHCEp 








NAME 


«X> 


AOc M. 







OATE BURIAL PERMIT ISSUER 



SK3NATURe-eO.OF 
HEALTH AGENT 



RECEIVED IN IHECITY/TOVYNOf: 



CLERICS 
SIGNATURE 



OATEOFRECOOO 



< 



200 




DEPARTMENT OF PUBLIC HEALTH 
REGISTRY OF VITAL RECORDS AND STATISTICS 

REPORT OF FETAL DEATH 




ATTENDANT 



DISPOSITION 



PERMIT 



I METHOD 


K/M-I^^jiar'OSITION (Name of Cemetery. Crematory, or other facilityl 


LOCATION (City or Town and Statel 


FUNERAL SERVICE LICENSEE 111 any) 


LICENSE a 


NAME OF FACILITY (II anyl 




DATE OF DISPOSITION 


DATE PERMIT ISSUED 

L 


CITY/TOWN ISSUING 


ISSUEO BY (signature of Health 


Agent) : 



INSTRUCTIONS: Complete a Report of Fetal Death only for fetal d eaths of twenty weeks or more gestation OR of a weight of 
350 grams or more. Complete front and reverse sides I D - . , .... , n . ' . 

of form within 10 days and send original copy to- v, * ^ Stat,S,,Cs/ Natalit V Data Unit " FD ' 

| 150 Mt. Vernon Street, 1 st Floor, Dorchester, MA 02125 



^ he C oI, MT ardin9 f ° r disposition P ermit: 00 not send the orig^a' ^port to the local Board of Health. Photocopy and forward only 
the FRONT of this form. The or.g.nal report must be sent to the Department of Public Health at the address listed above. 



201 



• FORMR-IOI-*9 

IK CERTIFICATE IS 
yr TO BE USED 
JTSIDEOF 
4SSACHUSETTS. 

}T VALID AFTER: 



S IS A PERMANENT RECORD, 
oatjr <hw»ble bUcfc Uk or approved 
t typewriter rib boa. Every hem of 
nutrioa should be carefully, supplied. 
ERATIO NS AND ERASURES IN 
S -CERTIFICATE ARE FOR8ID- 
t PENALTY FOR VIOLATION. 
: HUNDRED DOLLARS. 

. CHAP. 207, « 28, 28 A, «. *% 
1miCHAP.46.flt. 



vffiDICAL 

CERTIFICATES 
)N FILE 

COMMISSION 
UNFILE 




1 Place of Marriage 
Cky or Town _ 



■ (Pj not ttlg»iiat of village #f section of cHy or <o wn) 



t vjuuuuii uui caiuj di itt aa fiacijuficttfi 

DEPARTMENT OF PUBLIC HEALTH 
REGISTRY QT VITAL RECOROS ANO STATISTICS 

CERTIFICATE OF MARRIAGE 

This certificate raurt be delivered to the person before whom the 
marriage is to be contracted before he proceeds to solemnize the same 

2 Date of Marriage. 



(Month) 



(Pay) 



(Year) 



(Stale file number 

(City or town making r 
Registered No. 
. latcntion No. ■ 



3 FULL NAME 



GROOM 



3A. SURNAME 

AFTER MARRIAGE 



A DATE OF BIRTH 



6 RESIDENCE 
"NO. AST. 
CITY/ 
TOWN 



7 NUMBER OF 
MARRIAGE 
(1st, 2nd, Jrd> etc) 




S WIDOWED 
OR DIVORCED 



9 BIRTHPLACE 



(City or town) 



(State or country) 



10 MAIDEN NAME 
OF MOTHER 



II NAME OF 
FATHER 



12 FULL NAME 



BRIDE 



I2A SURNAME 

AFTER MARRIAGE 



13 DATEOF BIRTH 



14 OCCUPATION 



IS RESIDENCE 

NO. A ST.: 

CITY/ 

TOWN ^_ 



-ST.. 



ZIP 

.CODE. 



16 



number of 
Marriage 

(1st. 2nd. 3rd, etc ) 



17 WIDOWED 
OR DIVORCED 



18 BIRTHPLACE 



(Cky or town) 



(State or country) 



19 MAIDEN NAME 
OF MOTHER 



20 NAME OF 
FATHER 



21 THE INTENTION OF MARRIAGE by the above-mentioned persons was duly entered by me in the records of the Commt 

according to law^ this ; - day of 



TJ COURTWAIVER i ssua l ■ 
□ AGE ORDER (Month) 



(Name of Community) 



(Day) 



(Year) 



by. 



(City or Town Clerk or Registrar) 



22 I HEREBY CERTIFY that I joined the above-named pe 



Signature. 



Residence No.. 




marriage at No ■ __ ; ; 

(If marriage was solemnized in a church, give its NAME instead of street and i 

on ■ ■ ' ■ " - 



(Month) 



(Day) 



(Year) 



.Official station. 



(Minister of the Gospel, Clergyman, Priest, Rabbi, or Justice of ih 



.St., Qty or Town of. 



23 Certificate recorded by city or town dert. 



(Mooth). 



(Day) 



(Year) CLERK OR REGISTRAR 



202 



Cbr *Commontorallti o( ill a <*arrju <r< u 
DEPARTMENT OF PUBLIC HEALTH 
REGISTRY OF VITAL RECOROS ANO STATISTICS 

CERTIFICATE OF ABSOLUTE 
DIVORCE OR ANNULMENT 

(Chap. 208. Sec. 46 G.L.) 
R-408 



HUSSAMO - MAM€ 



usual ResocMCt . sr«cti aooacss 
u. 




I 0« LOCATION 



. COOHTY 



si*re 



WJU6CB OF IMG MAARtACC (« «<. Speea/rf 



wvee MAti£ 



HJU06N MAUE 

So. 



USUAL' ACSIOCMCC • STBCCt AOOFICSS 



orr. to™ on LOCAt«on 



COOK IT 



SfAre 



oa re of o<«rH <«*«_ our. r>j 
r. 



nuue(R OF THIS MARRIAGE (lit 2"W. Specttrf 



OAIC OF THIS MABWAOC 



N««8€H Of CM<l_0«£H BO«M ALIVC OF THIS M*RfllACE 



MOMBCfl OF CHILDREN UWO€R AC£ U tH THIS FAMH.T 




203 



REGISTRY OF VITAL RECORDS AND STATISTICS 
STAFF 



REGISTRAR 
Stanley E. Nyberg 



ADMINISTRATION 

Karin A. Barrett, Assistant Registrar 

Dean L. DiMartino, Director 

Ramona A. Irving, Administrative Assistant 

Pedro Fidalgo 

Tuyet Luong 



INFORMATION TECHNOLOGY 
Ian Skolnik 



INFORMATION UNIT 

Charlene J. Zion, Information Officer 

Kevin Y. Foster, Epidemiologist 



REGISTRATION UNIT 
Pauline M. McNulty, Director 
June A. Deloney. Supervisor 
Denise O'Gara, Paralegal 
Crystal Steward, Paralegal 
Tara Andrews 
Irene Chu 
Carolyn Edwards 
Robert E. McMahan 
Venita B. Morabito 
Mary E. Risser 
MaryLou F. Rossetti 
Phyllis Rotman 
Monica Smith 



STATISTICS UNIT 
Jane K. Purtill, Director 
Helen Ba 
Paul A. Budrow 
Robert A. Coffin III 
Hailekiros Gabreegziabher 
Annie B. Hobbs 
Judy Y. Lim 
Maureen L. McKean 
Ann-Marie Neault 
Waleska Ortiz 
Adele L. Pascar 
Sharon Pagnano 
Maria Vu 



RECORDS UNIT 

Harold L. Leonard, Supervisor 

Joseph R. Cummings, Supervisor 

Katherine Martinez, Vital Check Coordinator 

Michael Baker 

Christina Bocolos 

Pamela Corbin 

Trevor Hall 

Daniel Martel 

Donald T. McHugh 

Simon Smith 



205 



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